Clinical features, treatment, and prognosis of secukinumab-induced inflammatory bowel disease

Inflammatory bowel disease (IBD) is a rare adverse effect linked to secukinumab, with limited clinical data available. This study aimed to analyze the clinical features of secukinumab-induced IBD and to offer recommendations for the careful administration of secukinumab.

We conducted a retrospective analysis by gathering case reports and case series of secukinumab-induced IBD through a database search, with data collected until September 30, 2024.

A total of forty patients (21 males and 19 females) fulfilled the inclusion criteria, with a median age of 42 years (range 19, 70). The median time to IBD onset was 4 months following the initial dose (range 0.25, 53). The most common symptoms reported were abdominal pain (60.0%), diarrhea (37.5%), bloody diarrhea (32.5%), and fever (30.0%). Colonoscopy findings predominantly showed ulcers (62.5%) and inflammation (27.5%). Biopsy results revealed crypt microabscesses (22.5%), cryptitis (20.0%), inflammatory cellular infiltrates (20.0%), and both acute and chronic inflammation (22.5%). After discontinuation of secukinumab, patients reported symptom relief following treatment with systemic steroids (60.0%), targeted therapies (52.5%), and mesalamine (22.5%).

Comprehensive screenings are essential for patients prior to initiating secukinumab therapy. Gastrointestinal symptoms necessitate close monitoring during secukinumab treatment. Upon the diagnosis of IBD, secukinumab should be discontinued, and systemic steroid therapy should be initiated. Patients who do not respond or experience a relapse should be considered for immunosuppressive therapy.