Nabeeha Mohy-ud-din, MD1, Neil Carleton, MD, PhD1, Sandra El-Hachem, MD1, Heitham Abdul Baki, MD1, Aslam Syed, MD1, Parambir Dulai, MD2, Gursimran Kochhar, MD1
1Allegheny Health Network, Pittsburgh, PA; 2University of California San Diego, La Jolla, CA
Introduction: Secukinumab is a human monoclonal antibody and an inhibitor of IL-17A. It is indicated for treatment of Psoriatic Arthritis, Psoriasis and Ankylosing Spondylitis. There have been a few case reports documenting new or worsening IBD in patients being treated with secukinumab. However, large patient cohorts reporting this relationship are lacking. The aim of this study is to analyze if the use of secukinumab leads to increased risk of development of IBD.
Methods: A retrospective study was performed using a HIPPA-enabled web platform called Explorys (IBM, New York). Explorys contains de-identified data from approximately 62 million electronic health records. Data was obtained using the search criteria of ‘Secukinumab’ and ‘Inflammatory Bowel Disease’. A temporal relationship was established between secukinumab use and development of de-novo IBD. Demographics and management data were collected and compared using odds ratio with 95% confidence intervals.
Results: Sixty-two million electronic health records were analyzed. Of them, 2870 patients were noted to use secukinumab. Rates of de-novo IBD after secukinumab use were higher than the prevalence of IBD in the general population [3.2% vs 0.74%, RR-4.2 (95% CI 3.45-5.18)]. Patients with de-novo IBD after secukinumab use were younger [age < 65 - 78% vs 65%, OR 1.92 (1.17-3.15)] and more obese [BMI >30- 22% vs 7%, OR 3.91 (2.38-6.43)]. Additionally, they had higher proportion of patients with use of immunomodulators [67% vs 10%, OR 17.81 (11.49, 27.61)].
Discussion: The risk of developing de-novo IBD in patients with secukinumab use is higher compared to the general population. These patients were younger, more obese and more likely to use immunomodulators.
Citation: Nabeeha Mohy-ud-din, MD; Neil Carleton, MD, PhD; Sandra El-Hachem, MD; Heitham Abdul Baki, MD; Aslam Syed, MD; Parambir Dulai, MD; Gursimran Kochhar, MD. P1376 - DE NOVO INFLAMMATORY BOWEL DISEASE AFTER SECUKINUMAB USE: A POPULATION BASED ANALYSIS. Program No. P1376. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.