Secukinumab as a Potential Trigger of Inflammatory Bowel Disease in Ankylosing Spondylitis or Psoriatic Arthritis Patients

Ioana A. Onac; Benjamin D. Clarke; Cristina Tacu; Mark Lloyd; Vijay Hajela; Thomas Batty; Jamie Thoroughgood; Sandra Smith; Hannah Irvine; Diane Hill; Grace Baxter; Natalie Horwood; Suma Mahendrakar; Rizwan Rajak; Sian Griffith; Patrick D. W. Kiely; James Galloway


Rheumatology. 2021;60(11):5233-5238. 

In This Article


The absolute rates of new IBD in patients starting secukinumab are low. In addition, the majority of patients developing new gastrointestinal symptoms did not develop objective evidence of IBD or need to stop therapy.

Our experience would not support the practice of pre-screening all patients for IBD prior to starting anti-IL-17 therapy in the PsA group. However, our data suggest that in people with pre-existing IBD and, most importantly in those with AS, the risk of IBD flares is higher. It seems prudent for clinicians to consider alternative immune modulatory strategies for patients with pre-existing IBD, especially in the context of AS.

Further research to evaluate the characteristics of AS patients with no history of IBD should be considered in view of stratifying IBD risk prior to IL-17 inhibition.