Incidence rates of inflammatory bowel disease in patients with psoriasis, psoriatic arthritis and ankylosing spondylitis treated with secukinumab: a retrospective analysis of pooled data from 21 clinical trials

Objectives Here, we present the reported incidence rates of inflammatory bowel disease (IBD) in patients receiving treatment with secukinumab for psoriasis (PsO), psoriatic arthritis (PsA) or ankylosing spondylitis (AS), in a pooled analysis of 21 clinical trials. Methods Data from all patients who had received at least one dose of secukinumab were included. Safety analyses were conducted to evaluate cumulative IBD rates as well as per-year rates, by indication. Crohn’s disease (CD), ulcerative colitis (UC) and IBD unclassified (IBDU) events were analysed using exposure-adjusted incidence rates (patient incidence rates per 100 patient-years (PY)). Results A total of 7355 patients with a cumulative exposure of 16 226.9 PY were included in the pooled analysis. Among 5181 patients with PsO, there were 14 cases of UC, 5 cases of CD and 1 case of IBDU, with exposure adjusted incidence rates (EAIRs) of 0.13, 0.05 and 0.01, respectively. Of these 20 cases, 14 were new-onset. In 1380 patients with PsA, there were 3 cases of UC, 3 cases of CD and 2 cases of IBDU (EAIRs 0.08, 0.08 and 0.05); 7 of these represented new-onset cases. Among 794 patients with AS, there were 4 cases of UC, 8 cases of CD and 1 case of IBDU (EAIRs 0.2, 0.4 and 0.1); 9 were new-onset cases. In the per year analysis, the EAIRs for each indication did not increase over time with secukinumab treatment. Conclusions In this pooled secukinumab safety analysis of 7355 patients across 21 clinical trials, cases of IBD events (including CD, UC and IBDU) were uncommon.

[1]  S. Jo,et al.  Psoriasis increases the risk of concurrent inflammatory bowel disease: A population-based nationwide study in Korea. , 2019, Indian journal of dermatology, venereology and leprology.

[2]  J. Walsh,et al.  Evaluation of the comorbidity burden in patients with ankylosing spondylitis using a large US administrative claims data set , 2018, Clinical Rheumatology.

[3]  T. Luger,et al.  Secukinumab demonstrates high sustained efficacy and a favourable safety profile in patients with moderate‐to‐severe psoriasis through 5 years of treatment (SCULPTURE Extension Study) , 2018, Journal of the European Academy of Dermatology and Venereology : JEADV.

[4]  P. Sfikakis,et al.  Secukinumab after anti-tumour necrosis factor-α therapy: a phase III study in active rheumatoid arthritis , 2018, Scandinavian journal of rheumatology.

[5]  S. Feldman,et al.  Interleukin-17 inhibition: role in psoriasis and inflammatory bowel disease , 2018, The Journal of dermatological treatment.

[6]  M. Genovese,et al.  Secukinumab in Active Rheumatoid Arthritis after Anti-TNFα Therapy: A Randomized, Double-Blind Placebo-Controlled Phase 3 Study , 2017, Rheumatology and Therapy.

[7]  J. Curtis,et al.  Incidence of Inflammatory Bowel Disease Events in Adalimumab Clinical Trials Across Indications , 2017 .

[8]  M. Peppelenbosch,et al.  Prevalence and Phenotype of Concurrent Psoriasis and Inflammatory Bowel Disease , 2017, Inflammatory bowel diseases.

[9]  K. Patra,et al.  Efficacy and Safety of MEDI2070, an Antibody Against Interleukin 23, in Patients With Moderate to Severe Crohn's Disease: A Phase 2a Study. , 2017, Gastroenterology.

[10]  F. Blanco,et al.  Secukinumab in Active Rheumatoid Arthritis: A Phase III Randomized, Double‐Blind, Active Comparator– and Placebo‐Controlled Study , 2017, Arthritis & rheumatology.

[11]  D. Elewaut,et al.  FRI0444 Incidence of inflammatory bowel disease events in adalimumab clinical trials across indications , 2017 .

[12]  A. Kaser,et al.  Induction therapy with the selective interleukin-23 inhibitor risankizumab in patients with moderate-to-severe Crohn's disease: a randomised, double-blind, placebo-controlled phase 2 study , 2017, The Lancet.

[13]  M. Ohtsuki,et al.  Inflammatory bowel disease among patients with psoriasis treated with ixekizumab: A presentation of adjudicated data from an integrated database of 7 randomized controlled and uncontrolled trials , 2017, Journal of the American Academy of Dermatology.

[14]  L. Skov,et al.  Association between psoriasis and inflammatory bowel disease: a Danish nationwide cohort study , 2016, The British journal of dermatology.

[15]  S. Targan,et al.  A Randomized, Double-Blind, Placebo-Controlled Phase 2 Study of Brodalumab in Patients With Moderate-to-Severe Crohn’s Disease , 2016, The American Journal of Gastroenterology.

[16]  K. Katsanos,et al.  Psoriasis and inflammatory bowel disease: links and risks , 2016, Psoriasis.

[17]  R. Dauskardt,et al.  Fragility of epidermis in newborns, children and adolescents , 2016, Journal of the European Academy of Dermatology and Venereology : JEADV.

[18]  Søren Brunak,et al.  Analysis of five chronic inflammatory diseases identifies 27 new associations and highlights disease-specific patterns at shared loci , 2016, Nature Genetics.

[19]  Tariq Ahmad,et al.  Inherited determinants of Crohn's disease and ulcerative colitis phenotypes: a genetic association study , 2016, The Lancet.

[20]  J. Korzenik,et al.  Inflammatory Bowel Disease Provoked by Etanercept: Report of 443 Possible Cases Combined from an IBD Referral Center and the FDA , 2016, Digestive Diseases and Sciences.

[21]  M. Dougados,et al.  Secukinumab, an Interleukin-17A Inhibitor, in Ankylosing Spondylitis. , 2015, The New England journal of medicine.

[22]  S. Gaffen,et al.  Gut-Busters: IL-17 Ain't Afraid of No IL-23. , 2015, Immunity.

[23]  D. M. van der Heijde,et al.  Secukinumab Inhibition of Interleukin-17A in Patients with Psoriatic Arthritis. , 2015, The New England journal of medicine.

[24]  F. Vanaclocha,et al.  Secukinumab is superior to ustekinumab in clearing skin of subjects with moderate to severe plaque psoriasis: CLEAR, a randomized controlled trial. , 2015, Journal of the American Academy of Dermatology.

[25]  F. Romero,et al.  Consensus statement on a framework for the management of comorbidity and extra-articular manifestations in rheumatoid arthritis , 2015, Rheumatology International.

[26]  B. Elewski,et al.  Secukinumab in plaque psoriasis--results of two phase 3 trials. , 2014, The New England journal of medicine.

[27]  A. Boonen,et al.  The epidemiology of extra-articular manifestations in ankylosing spondylitis: a population-based matched cohort study , 2014, Annals of the rheumatic diseases.

[28]  Kristin Stephens,et al.  Vedolizumab as induction and maintenance therapy for Crohn's disease. , 2013, The New England journal of medicine.

[29]  S. Androudi,et al.  Secukinumab in the treatment of noninfectious uveitis: results of three randomized, controlled clinical trials. , 2013, Ophthalmology.

[30]  K. Farkas,et al.  Predictors of relapse in patients with Crohn's disease in remission after 1 year of biological therapy , 2013, Alimentary pharmacology & therapeutics.

[31]  M. De Vos,et al.  Microscopic gut inflammation in axial spondyloarthritis: a multiparametric predictive model , 2012, Annals of the rheumatic diseases.

[32]  J. Berthelot,et al.  Development of inflammatory bowel disease during anti-TNF-α therapy for inflammatory rheumatic disease: a nationwide series. , 2012, Joint, bone, spine : revue du rhumatisme.

[33]  A. Qureshi,et al.  Psoriasis, psoriatic arthritis and increased risk of incident Crohn's disease in US women , 2012, Annals of the rheumatic diseases.

[34]  Marc Vandemeulebroecke,et al.  Secukinumab, a human anti-IL-17A monoclonal antibody, for moderate to severe Crohn's disease: unexpected results of a randomised, double-blind placebo-controlled trial , 2012, Gut.

[35]  Christian Gieger,et al.  Combined analysis of genome-wide association studies for Crohn disease and psoriasis identifies seven shared susceptibility loci. , 2012, American journal of human genetics.

[36]  W. El-Matary,et al.  Relapse Rate Following Azathioprine Withdrawal in Maintaining Remission for Crohn’s Disease: A Meta-Analysis , 2011, Digestive Diseases and Sciences.

[37]  P. Moayyedi,et al.  Efficacy of Biological Therapies in Inflammatory Bowel Disease: Systematic Review and Meta-Analysis , 2011, The American Journal of Gastroenterology.

[38]  Michael Weisman,et al.  Association of Variants at 1q32 and STAT3 with Ankylosing Spondylitis Suggests Genetic Overlap with Crohn's Disease , 2010, PLoS genetics.

[39]  P. Tak,et al.  Effects of AIN457, a Fully Human Antibody to Interleukin-17A, on Psoriasis, Rheumatoid Arthritis, and Uveitis , 2010, Science Translational Medicine.

[40]  D. M. van der Heijde,et al.  The joint-gut axis in inflammatory bowel diseases. , 2010, Journal of Crohn's & colitis.

[41]  L. Peyrin-Biroulet,et al.  Anti-TNF therapy in inflammatory bowel diseases: a huge review. , 2010, Minerva gastroenterologica e dietologica.

[42]  I. Schaefer,et al.  Co-morbidity and age-related prevalence of psoriasis: Analysis of health insurance data in Germany. , 2010, Acta dermato-venereologica.

[43]  A. Kimball,et al.  The burden of autoimmune disease: a comparison of prevalence ratios in patients with psoriatic arthritis and psoriasis. , 2009, Journal of the American Academy of Dermatology.

[44]  Richard A Flavell,et al.  A protective function for interleukin 17A in T cell–mediated intestinal inflammation , 2009, Nature Immunology.

[45]  J. Dreiher,et al.  Psoriasis associated with ulcerative colitis and Crohn's disease , 2009, Journal of the European Academy of Dermatology and Venereology : JEADV.

[46]  K. Maloy The Interleukin‐23 / Interleukin‐17 axis in intestinal inflammation , 2008, Journal of internal medicine.

[47]  N. Prescott,et al.  Psoriasis is associated with pleiotropic susceptibility loci identified in type II diabetes and Crohn disease , 2007, Journal of Medical Genetics.

[48]  D. M. van der Heijde,et al.  Differences in the incidence of flares or new onset of inflammatory bowel diseases in patients with ankylosing spondylitis exposed to therapy with anti-tumor necrosis factor alpha agents. , 2007, Arthritis and rheumatism.

[49]  Judy H. Cho,et al.  A Genome-Wide Association Study Identifies IL23R as an Inflammatory Bowel Disease Gene , 2006, Science.

[50]  A. Timmer Environmental Influences on Inflammatory Bowel Disease Manifestations , 2003, Digestive Diseases.

[51]  A. Zinsmeister,et al.  Etanercept for active Crohn's disease: a randomized, double-blind, placebo-controlled trial. , 2001, Gastroenterology.

[52]  B. Korelitz,et al.  Effects of nonsteroidal antiinflammatory drugs on inflammatory bowel disease: a case-control study , 2000, American Journal of Gastroenterology.

[53]  M. De Vos,et al.  Long-term evolution of gut inflammation in patients with spondyloarthropathy. , 1996, Gastroenterology.

[54]  A. Peña,et al.  Environmental risk factors in inflammatory bowel disease. , 1996, Hepato-gastroenterology.

[55]  J M Robins,et al.  Estimation of a common effect parameter from sparse follow-up data. , 1985, Biometrics.

[56]  D. Iliopoulos,et al.  Environmental triggers in IBD: a review of progress and evidence , 2018, Nature Reviews Gastroenterology & Hepatology.

[57]  F. Vanaclocha,et al.  Secukinumab is superior to ustekinumab in clearing skin of subjects with moderate‐to‐severe plaque psoriasis up to 1 year: Results from the CLEAR study , 2017, Journal of the American Academy of Dermatology.

[58]  M. Parkes,et al.  Relapse after withdrawal from anti-TNF therapy for inflammatory bowel disease , 2016 .

[59]  P. Rutgeerts,et al.  Ustekinumab as Induction and Maintenance Therapy for Crohn's Disease. , 2016, The New England journal of medicine.

[60]  D. Gladman,et al.  Abstracts of the 5th Congress of the Psoriasis International Network, 7-9 July 2016, Paris. , 2016, Journal of the European Academy of Dermatology and Venereology : JEADV.

[61]  David C. Wilson,et al.  Host-microbe interactions have shaped the genetic architecture of inflammatory bowel disease , 2012, Nature.

[62]  A. Andoh,et al.  Neutralization of interleukin-17 aggravates dextran sulfate sodium-induced colitis in mice. , 2004, Clinical immunology.

[63]  A. Timmer Environmental influences on inflammatory bowel disease manifestations. Lessons from epidemiology. , 2003, Digestive diseases.