IL-17 Antagonists Do Not Elevate Risk of Inflammatory Bowel Disease

Treatment with IL-17 antagonists does not increase the risk for inflammatory bowel disease in patients with psoriasis, psoriatic arthritis, ankylosing spondylitis, and rheumatoid arthritis, according to a systematic review and meta-analysis published online in PLoS One.

“Cases of inflammatory bowel disease during treatment with IL-17 antagonists have been reported from trials in psoriasis, psoriatic arthritis, and ankylosing spondylitis,” researchers wrote. “The aim of this study was to assess the overall risk for development of inflammatory bowel disease due to IL-17 inhibition.”

The meta-analysis spanned 66 studies involving more than 19,000 patients with psoriasis, psoriatic arthritis, ankylosing spondylitis, and rheumatoid arthritis who were treated with secukinumab (Cosentyx), ixekizumab (Taltz), and brodalumab (Siliq) between 2010 and 2018.
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Eleven incident cases of inflammatory bowel disease were reported in patients receiving induction treatment, according the study, and 33 cases were reported during both the induction and maintenance phases of treatment.

When researchers considered a worst-case scenario, in which all cases of inflammatory bowel disease were considered new diagnoses, the risk of new-onset inflammatory bowel disease during induction was no higher than a best-case scenario, in which all inflammatory bowel disease cases that were unclear were considered prevalent cases. Furthermore, the risk of inflammatory bowel disease was no different from placebo when data for maintenance and long-term extension studies was included in the analysis.

“In conclusion, while we did not find an increased risk for inflammatory bowel disease after initiation of anti-IL-17 directed therapies, close monitoring of symptoms and biomarkers which may suggest inflammatory bowel disease before and during treatment with secukinumab, ixekizumab, and brodalumab appears reasonable,” researchers wrote.

—Jolynn Tumolo

Reference

Burisch J, Eigner W, Schreiber S, et al. Risk for development of inflammatory bowel disease under inhibition of interleukin 17: a systematic review and meta-analysis. PLoS One. 2020;15(5):e0233781. doi:10.1371/journal.pone.0233781