Li Ronghui, Lei Haibo, Wang Chunjiang, Liu Xiang
Department of Clinical Pharmacy, Xiangtan Central Hospital (The affiliated hospital of Hunan university), 120 Heping Road, Yuhu District, Xiangtan, 411100, Hunan, China.
Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China.
Eur J Med Res. 2025 Jan 19;30(1):37. doi: 10.1186/s40001-025-02295-y.
Inflammatory bowel disease (IBD) is a rare adverse effect linked to secukinumab, with limited clinical data available. This study aimed to analyze the clinical features of secukinumab-induced IBD and to offer recommendations for the careful administration of secukinumab.
We conducted a retrospective analysis by gathering case reports and case series of secukinumab-induced IBD through a database search, with data collected until September 30, 2024.
A total of forty patients (21 males and 19 females) fulfilled the inclusion criteria, with a median age of 42 years (range 19, 70). The median time to IBD onset was 4 months following the initial dose (range 0.25, 53). The most common symptoms reported were abdominal pain (60.0%), diarrhea (37.5%), bloody diarrhea (32.5%), and fever (30.0%). Colonoscopy findings predominantly showed ulcers (62.5%) and inflammation (27.5%). Biopsy results revealed crypt microabscesses (22.5%), cryptitis (20.0%), inflammatory cellular infiltrates (20.0%), and both acute and chronic inflammation (22.5%). After discontinuation of secukinumab, patients reported symptom relief following treatment with systemic steroids (60.0%), targeted therapies (52.5%), and mesalamine (22.5%).
Comprehensive screenings are essential for patients prior to initiating secukinumab therapy. Gastrointestinal symptoms necessitate close monitoring during secukinumab treatment. Upon the diagnosis of IBD, secukinumab should be discontinued, and systemic steroid therapy should be initiated. Patients who do not respond or experience a relapse should be considered for immunosuppressive therapy.
炎症性肠病（IBD）是司库奇尤单抗相关的一种罕见不良反应，可用的临床数据有限。本研究旨在分析司库奇尤单抗诱导的IBD的临床特征，并为司库奇尤单抗的谨慎使用提供建议。
我们通过数据库检索收集司库奇尤单抗诱导的IBD的病例报告和病例系列进行回顾性分析，数据收集至2024年9月30日。
共有40例患者（21例男性和19例女性）符合纳入标准，中位年龄为42岁（范围19至70岁）。IBD发病的中位时间为首次给药后4个月（范围0.25至53个月）。报告的最常见症状为腹痛（60.0%）、腹泻（37.5%）、便血（32.5%）和发热（30.0%）。结肠镜检查结果主要显示溃疡（62.5%）和炎症（27.5%）。活检结果显示隐窝微脓肿（22.5%）、隐窝炎（20.0%）、炎性细胞浸润（20.0%）以及急性和慢性炎症（22.5%）。停用司库奇尤单抗后，患者报告在接受全身用类固醇（60.0%）、靶向治疗（52.5%）和美沙拉嗪（22.5%）治疗后症状缓解。
在开始司库奇尤单抗治疗前，对患者进行全面筛查至关重要。在司库奇尤单抗治疗期间，胃肠道症状需要密切监测。一旦诊断为IBD，应停用司库奇尤单抗，并开始全身用类固醇治疗。对无反应或复发的患者应考虑免疫抑制治疗。
