Original scientific paper
A Manifestation of Ulcerative Colitis During Treatment for Severe Plaque Psoriasis with Ixekizumab – A Report of Two Cases and Review of the Literature
Martin Tichy
orcid.org/0000-0002-4925-2634
; Department of Dermatology and Venereology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Rep
Jan Sternbersky
; Department of Dermatology and Venereology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Rep
Viktor Palla
; Department of Dermatology and Venereology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Rep
Abstract
IL-17 inhibitors belong to the group of the most effective
and highly safe biological preparations intended for the treatment
of psoriasis, and in the case of secukinumab and ixekizumab, also for
the treatment of some immune-mediated inflammatory diseases of
the joints. Despite initial expectations, they did not prove to be effective
for the treatment of non-specific bowel inflammations (IBD).
On the contrary, IBD worsening was reported in some cases where
IL-17 inhibitors were used, and registration studies were terminated
for this indication. In clinical studies, extensive meta-analyses of IL-17
inhibitor use for psoriasis and joint inflammation indications generally
did not demonstrate any statistically significant increase in the
risk of de-novo IBD with this type of treatment. Data from real-time
practice are mostly similar. The literature describes individual cases
with an obvious relation of de novo IBD development subsequent to
treatment with IL-17 inhibitors in registered indications. The activation
of latent, thus far clinically asymptomatic bowel inflammation is usually
expected. Therefore, a careful review of medical history focused
on bowel problems in personal and family history is necessary before
starting therapy with IL-17 inhibitors. We present a similar experience
with de novo onset of ulcerative colitis in two patients treated for psoriasis
with ixekizumab, with associated psoriatic arthritis in one case.
Keywords
psoriasis, ixekizumab, ulcerative colitis
Hrčak ID:
274693
URI
Publication date:
15.12.2021.
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