医学
塞库金单抗
伊克泽珠单抗
银屑病性关节炎
强直性脊柱炎
银屑病
溃疡性结肠炎
恶化
疾病
乌斯特基努马
免疫学
痹症科
维多利祖马布
关节炎
英夫利昔单抗
内科学
皮肤病科
作者
Marine Fauny,David Moulin,Ferdinando D’Amico,Patrick Netter,Nadine Petitpain,Djésia Arnone,Jean‐Yves Jouzeau,Damien Lœuille,Laurent Peyrin‐Biroulet
标识
DOI:10.1136/annrheumdis-2020-217927
摘要
Secukinumab, ixekizumab and brodalumab are monoclonal antibody therapies that inhibit interleukin (IL)-17 activity and are widely used for the treatment of psoriasis, psoriatic arthritis and ankylosing spondylitis. The promising efficacy results in dermatology and rheumatology prompted the evaluation of these drugs in Crohn's disease and ulcerative colitis, but the onset of paradoxical events (disease exacerbation after treatment with a theoretically curative drug) prevented their approval in patients with inflammatory bowel diseases (IBDs). To date, the pathophysiological mechanisms underlying these paradoxical effects are not well defined, and there are no clear guidelines for the management of patients with disease flare or new IBD onset after anti-IL-17 drug therapy. In this review, we summarise the literature on putative mechanisms, the clinical digestive effects after therapy with IL-17 inhibitors and provide guidance for the management of these paradoxical effects in clinical practice.
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