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Vol. 20. Issue 3.
Pages 123-127 (March 2024)
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Vol. 20. Issue 3.
Pages 123-127 (March 2024)
Original article
Is the use of secukinumab after anti-TNF therapy greater than expected for the risk of developing inflammatory bowel disease?
El uso de secukinumab tras la terapia anti-TNF es mayor de lo esperado por el riesgo de desarrollar enfermedad inflamatoria intestinal?
Fatih Albayraka,
Corresponding author
drfalbayrak@yahoo.com

Corresponding author.
, Mustafa Gürb, Ahmet Karataşb, Süleyman Serdar Kocab, Bünyamin Kısacıkc
a Department of Internal Medicine, Division of Rheumatology, Dr. Ersin Arslan Training and Research Hospital, Şehitkamil, Gaziantep, Turkey
b Department of Internal Medicine, Division of Rheumatology, Fırat University Faculty of Medicine, Elazığ, Turkey
c Department of Rheumatology, Gaziantep Sanko Hospital, Şehitkamil, Gaziantep, Turkey
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Tables (3)
Table 1. Demographic characteristics of patients.
Table 2. Clinical and demographic characteristics of cases with IBD.
Table 3. Clinical and demographic characteristics of patients with and without IBD.
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Abstract
Objective

In this study, our objective was to present real-life data on the incidence of inflammatory bowel disease (IBD) among patients receiving secukinumab treatment.

Methods

The study consisted of 209 patients who had prior exposure to anti-tumor necrosis factor (TNF) or were biologically naive. Patients with a pre-existing history of IBD were excluded from the study.

Results

Of the 209 patients in the study, 176 (84.3%) had ankylosing spondylitis, while 33 (15.7%) had psoriatic arthritis. 112 (53.6%) patients had prior exposure to at least one anti-TNF treatment before initiating secukinumab. IBD developed in 10 (4.8%) of the 209 patients. The incidence of IBD among patients who initiated secukinumab as their first biologic agent was 1%. For patients who had previously received any anti-TNF treatment and subsequently transitioned to secukinumab, the incidence of IBD was 8% (p=0.018, odds ratio (OR): 8.38, 95% CI: 1.04–67.45). A mean of 3.67 months (±4.3) after anti-TNF use, whereas IBD symptoms developed in the biologically naive patient after 15 months.

Conclusion

Our study observed IBD incidence in 4.8% of patients using secukinumab. Patients who initiated secukinumab after previous anti-TNF treatment exhibited a significantly higher rate and risk of developing IBD. The onset of IBD occurred earlier in these patients (mean 3.67 months), whereas a single case of IBD showed a longer duration (15 months). Further studies with larger patient numbers are warranted to provide a more comprehensive understanding of our findings.

Keywords:
Secukinumab
Inflammatory bowel disease
Ankylosing spondylitis
Psoriatic arthritis
Real-world data
Resumen
Objetivo

En este estudio, nuestro objetivo fue presentar datos de la vida real sobre la incidencia de la enfermedad inflamatoria intestinal (EII) entre los pacientes que reciben tratamiento con secukinumab.

Métodos

El estudio consistió en 209 pacientes que habían tenido una exposición previa al factor de necrosis antitumoral (TNF) o eran biológicamente naive. Los pacientes con antecedentes preexistentes de EII fueron excluidos del estudio.

Resultados

De los 209 pacientes del estudio, 176 (84,3%) tenían espondilitis anquilosante, mientras que 33 (15,7%) tenían artritis psoriásica. 112 (53,6%) pacientes tenían exposición previa a al menos un tratamiento anti-TNF antes de iniciar secukinumab. La EII se desarrolló en 10 (4,8%) de los 209 pacientes. La incidencia de EII entre los pacientes que iniciaron secukinumab como primer agente biológico fue del 1%. Para los pacientes que habían recibido previamente algún tratamiento anti-TNF y posteriormente hicieron la transición a secukinumab, la incidencia de EII fue del 8% (p=0,018, odds ratio (OR): 8,38, IC del 95%: 1,04-67,45). Una media de 3,67 meses (±4,3) después del uso de anti-TNF, mientras que los síntomas de la EII se desarrollaron en el paciente biológicamente naive después de 15 meses.

Conclusión

Nuestro estudio observó una incidencia de EII en el 4,8% de los pacientes que usaban secukinumab. Los pacientes que iniciaron secukinumab después de un tratamiento anti-TNF previo mostraron una tasa y un riesgo significativamente mayores de desarrollar EII. El inicio de la EII ocurrió antes en estos pacientes (media de 3,67 meses), mientras que un solo caso de EII mostró una duración más prolongada (15 meses). Se justifican más estudios con un mayor número de pacientes para proporcionar una comprensión más completa de nuestros hallazgos.

Palabras clave:
Secukinumab
Enfermedad inflamatoria intestinal
Espondilitis anquilosante
Artritis psoriásica
Datos del mundo real

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