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Risk of IBD Higher With Apremilast, Lower With Etanercept for Psoriasis, PsA, and AS

Risk of developing inflammatory bowel disease (IBD) is greater in IL-17 inhibitors new-users than in apremilast new-users, but not in etanercept new-users, for patients with psoriasis, psoriatic arthritis (PsA), and ankylosing spondylitis (AS).

Researchers investigated whether IL-17 inhibitor initiation in real life is associated with a higher risk of IBD in patients with psoraisis, PsA, or AS in a nationwide cohort study involving the French national health data system database.

In total, 16,793 patients starting an IL-17 inhibitor, 20,556 starting apremilast, and 10,245 starting etanercept were included. IBD occurred in 132 cases, of which, 72 (0.43%) were in IL-17 new-users, 11 (0.05%) in apremilast new-users, and 49 (0.48%) in etanercept new-users. Thus, the risk of IBD was significantly greater with IL-17 than apremilast, but not etanercept new-users.

“Compared with patients initiating etanercept that displayed the same severity of the underlying disease, IL17i new-users did not present a higher risk of IBD,” concluded the study authors. “These results need to be confirmed in other large databases,” they added.

Reference
Penso L, Bergqvist C, Meyer A, et al. Risk of inflammatory bowel disease in patients with psoriasis, psoriatic arthritis and ankylosing spondylitis initiating interleukin 17 inhibitors: a nationwide population-based study using the French national health data system. Arthritis Rheumatol. Published online July 19, 2021. doi:10.1002/art.41923

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