IL-17 Inhibitors Examined for Association With IBD

Patients initiating treatment for psoriasis (PsO), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) with interleukin 17 inhibitors (IL-17i) were not at higher risk of developing inflammatory bowel disease than patients being treated with etanercept, although the risk was greater than among patients treated with apremilast, French investigators concluded.

Using the French national health data system database, the researchers conducted a nationwide cohort study that identified all adults with PsO and PsA or AS who began using IL17is during the period 2016-2019, and included patients using apremilast and etanercept for treatment of PsO, PsA, or AS, who had not been exposed to IL-17s. The development of IBD in a time-to-event analysis was the primary endpoint.

The researchers included 16,793 new-users of IL-17is (mean age 48.4±13 years; 46% men); 20,556 new users of apremilast (mean age 52.5±14.6 years; 53% men); and 10,245 new users of etanercept (mean age 46.3±15 years; 44% men). They identified 132 patients who developed IBD: 72 (0.43%) among the IL17i cohort; 11 (0.05%) among apremilast new users; and 49 (0.48%) among patients being treated with etanercept. Most IBD cases occurred after 6 months of exposure (82%, 55%, and 76% respectively).

“After propensity score weighting, the risk of IBD was significantly greater with IL17i than apremilast (HRw 3.8, 95%CI 2.1-6.8),” the investigators reported. “No difference was observed between IL17i and etanercept new-users (HRw 0.8, 95%CI 0.5-1.2).”

—Rebecca Mashaw

Reference:

Penso L, Bergqvist C, Meyer A, et al. Risk of inflammatory bowel disease in patients with psoriasis, psoriatic arthritis and ankylosing spondylitis initiating interleukin 17 inhibitors: a nationwide population-based study using the French national health data system. Arthritis Rheumatol. Published online July 19, 2021.