Retrospective Analysis of Demographic and Clinical Data of Psoriasis Patients Who Developed Inflammatory Bowel Disease Under Secukinumab and Ixekizumab Treatment

Introduction: The aim of this study was to retrospectively investigate the frequency of inflammatory bowel disease (IBD) and the demographic and clinical characteristics of psoriasis (PsO) patients exposed to IL-17A inhibitors. Method: Health data of 2,264 PsO patients who had received at least one dose of ixekizumab or secukinumab were retrospectively reviewed. Demographic data, clinical characteristics, symptoms consistent with IBD and confirmed IBD diagnoses of the patients were collected. Among the patients presenting with IBD-related symptoms during follow-up, those diagnosed with IBD after gastroenterology consultation were additionally recorded. Results: Among the 2,264 patients, 28 individuals (1.2%) reported gastrointestinal symptoms consistent with IBD (diarrhea, abdominal pain, bloody stool). The median time from initiation of IL-17A inhibitor therapy to symptom onset was 5.8 months. Of the symptomatic patients, 18 were female (64.3%) and 10 were male (35.7%). Fifteen patients (53.6%) were secukinumab users, and 13 (46.4%) were ixekizumab users; there was no significant difference between the drug groups in terms of symptom frequency (P=0.67). Following gastroenterological evaluation, seven patients (0.3%) were diagnosed with IBD, four of whom were secukinumab and three were ixekizumab users (P=0.72). Among the confirmed cases, three had ulcerative colitis and four had Crohn’s disease. Conclusion: Gastrointestinal symptoms were observed in 1.2% of the study population, while the rate of confirmed IBD after gastroenterological evaluation was 0.3%. This rate is similar to that of the general population. The distribution of ulcerative colitis and Crohn’s disease cases was equal between ixekizumab and secukinumab users. Monitoring for gastrointestinal symptoms during the first six months of treatment is important.