Inflammatory Bowel Disease Onset During Secukinumab Treatment: Real Concern or Just an Expression of Dysregulated Immune Response?
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Up to December 2018, eight cases of new-onset inflammatory bowel disease (IBD) were reported in the literature in patients being treated with secukinumab, an interleukin-17A antagonist prescribed for dermatologic or rheumatologic indications. The duration of secukinumab treatment ranged from a single administration to 12 months of treatment.
The aim of our investigation was to estimate the cumulative incidence of new-onset IBD in patients treated with secukinumab for either dermatologic or rheumatologic indications.
We carried out a survey among the dermatology and rheumatology centres in the Sicilian region (Italy) in order to identify the number of patients treated with secukinumab in the previous 24 months (November 2016–November 2018), and to understand how many of these patients eventually developed IBD after the start of secukinumab therapy.
Overall, four cases of IBD during secukinumab treatment were identified, with higher variability in time to onset compared with what has been previously reported, i.e. from 1 month to 5 years of secukinumab exposure. Overall, 434 patients were treated with secukinumab in Sicily between November 2016 and November 2018, and approximately 1% of these patients developed new-onset IBD.
Careful clinical examination of patients with respect to possible susceptibility to IBD prior to secukinumab therapy is advised.
The authors wish to thank the following members of the SN-IBD, and colleagues from the Dermatology and Rheumatology Units (in alphabetical order): Fabiola Atzeni, MD, Rheumatology, Policlinico ‘G. Martino’, University of Messina, Messina; Carmelo Bertolami, MD, Gastroenterology Unit, A.O.O.R. ‘Papardo Piemonte’, Messina; Maria Rita Bongirono, MD, Institute of Dermatology, University of Palermo, Palermo; Antonio Carroccio, MD, Internal Medicine Unit, A.O. ‘Giovanni Paolo II’, Sciacca; Serafinella Cannavò, Dermatology, Policlinico ‘G. Martino’, University of Messina, Messina; Aldo Mollica-Colella, MD, Rheumatology Unit, A.O.O.R. ‘Papardo Piemonte’, Messina; Roberto di Mitri, MD, Gastroenterology and Endoscopy Unit, A.R.N.A.S. ‘Civico Di Cristina Benfratelli’, Palermo; Serena Garufi, MD, Gastroenterology Unit, A.O.S. Elia, P.O. Raimondi, Caltanisetta (CL); Claudio Guarneri, MD, Dermatology, Policlinico ‘G. Martino’, University of Messina, Messina; Gaetano Inserra, MD, Gastroenterology Unit, A.O.U. Policlinico – “Vittorio Emanuele”, Catania; Michele Lo Re, Dermatology, A.O.O.R. ‘Papardo Piemonte’, Messina; Antonio Magnano, Gastroenterology Unit, A.O.U. Policlinico – “Vittorio Emanuele”, Catania; Giovanni Magrì, MD, Gastroenterology Unit, A.O. ‘Santa Marta e S. Venera’, Acireale (CT); Salvatore Pellegrino, Paediatric Gastroenterology, Policlinico ‘G. Martino’, University of Messina, Messina; Sara Renna, MD, IBD-Unit, “Villa Sofia-Cervello Hospital, Palermo; Barbara Scrivo, MD, Gastroenterology and Hepatology Unit, A.O.U. Policlinico “P. Giaccone”, Palermo; Antonino Trovatello: Surgery Unit, A.O. ‘Umberto I’, Syracuse; Roberto Vasallo, MD, Gastroenterology and Endoscopy Unit, A.O. ‘Buccheri La Ferla Fatebenefratelli’, Palermo, Italy.
Compliance with Ethical Standards
No funding was received to conduct this study.
Conflicts of Interest
Walter Fries, Alessandra Belvedere, Maria Cappello, Ambrogio Orlando and Gianluca Trifirò have no conflicts of interest to declare.
The protocol was approved by the local Ethics Committee of the coordinating centre (Messina; protocol n. 45/19). Written consent was not required.
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