Secukinumab failure in Crohn's disease: the yeast connection?

We read with great interest the article by Hueber et al 1 reporting on the dramatic failure of secukinumab, an anti-IL17A monoclonal antibody, in Crohn's disease (CD). This multicentre phase IIa study compared secukinumab with placebo in 59 patients with established moderate to severe CD. The study was prematurely stopped because the prespecified criterion for futility was met; for the first time to our knowledge in the history of recent CD trials, a statistical significant difference of mean Crohn's Disease Activity Index (CDAI) (between weeks 4 and 10) was observed in favour of placebo. Of the seven serious adverse events suspected to be drug related, five were worsening of CD, four on secukinumab. The study, thus, clearly showed that pharmacological blockade of IL-17A does not improve CD, but that it could …