New onset severe ulcerative colitis following Ixekizumab therapy

Abstract

Ixekizumab is one of the three biologic agents including Secukinumab and Brodalumab that targets the Interleukin-17 (IL-17) pathway to reduce inflammation in psoriasis and ankylosing spondylitis. In this report we present the case of 42-year-old woman, who was diagnosed with psoriasis and psoriatic arthritis. One week after first administration of Ixekizumab, she developed diffuse abdominal pain, bloody diarrhea (7-8 stools/day) and fever. Following imaging (colonoscopy, computed tomography) and laboratory investigations, she was diagnosed with acute severe ulcerative colitis complicated with toxic megacolon. The medical treatment (first corticotherapy, then infliximab) has failed and the patient needed emergency colectomy. Based on the immunological mechanisms and the observation from other studies, Ixekizumab should be considered an etiology for new-onset inflammatory bowel disease.

Total Proctocolectomy Resulting from Toxic Megacolon in A Young Patient with Ulcerative Rectocolitis: Systematic Review and Case Report

“…Table 1: Compares the reports found in the literature [3][4][5][6][7][8][9]. These are studies with 1 or more patients described, comparing them based on common factors, such as gender, age at onset of symptoms, clinic and treatment, as well as prognosis.…”

Psoriasis in children and adolescents

“…Da Infektionen allgemein unter Therapie schwerer verlaufen können, sollten vor Therapiebeginn alle Lebendimpfungen komplettiert werden. Aufgrund ihres Wirkmechanismus kommen Candida-Infektionen unter IL-17-Inhibitoren etwas häufiger vor; auch entzündliche Darmerkrankungen scheinen durch diese Therapeutika begünstigt zu werden [ 14 ]. Eine Wirkminderung aufgrund neutralisierender Antikörper ist am ehesten bei Adalimumab möglich.…”