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Real-world risk of new-onset inflammatory bowel disease among patients with psoriasis exposed to interleukin 17 inhibitors

Published:April 11, 2020DOI:https://doi.org/10.1016/j.jaad.2020.04.010

      Background

      Information on the real-world risk of inflammatory bowel disease (IBD) among patients with psoriasis exposed to interleukin-17 inhibitor (IL-17i) is limited.

      Objective

      To compare IBD risk in patients with psoriasis with and without IL-17i exposure.

      Methods

      Retrospective cohort analysis of patients with psoriasis with and without IL-17i exposure identified by using electronic health records data. Primary outcomes were 6-month and 1-year IBD incidence.

      Results

      Crude 6-month IBD incidence was 0.16% (3/1821) among patients with psoriasis exposed to any IL-17i, 0.24% (3/1246) among those exposed to secukinumab alone, and 0.11% (239/213,060) among those unexposed. Crude 1-year IBD incidence was 0.27% (5/1821) among IL-17i–exposed patients with psoriasis, 0.32% (4/1246) among those exposed to secukinumab alone, and 0.19% (412/213,060) among those unexposed. In adjusted analysis, there was no significant difference in odds of developing IBD at 6 months (odds ratio, 1.42; 95% confidence interval, 0.45-4.43) and 1 year (odds ratio, 1.37; 95% confidence interval, 0.57-3.33) between exposed and unexposed patients with psoriasis. Similarly, there was no significant difference in odds of developing IBD at 6 months and 1 year between secukinumab-exposed and -unexposed patients with psoriasis.

      Limitations

      Analysis may have been limited by the low number of outcome events.

      Conclusion

      The incidence of IBD among patients with psoriasis exposed to IL-17i is low, and the risk appears similar to that for unexposed patients with psoriasis.

      Key words

      Abbreviations used:

      CD (Crohn's disease), CI (confidence interval), IBD (inflammatory bowel disease), ICD (International Classification of Diseases), IL (interleukin), IL-17i (interleukin 17 inhibitor), IR (incidence rate), OR (odds ratio), Th (T helper), UC (ulcerative colitis), PY (person-years)
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