IBD risk similar between IL-17 inhibitor and etanercept

In patients with psoriasis, psoriatic arthritis, and ankylosing spondylitis, use of an interleukin (IL)17-inhibitor (IL17i) does not contribute to an increase in the risk of inflammatory bowel disease (IBD) when compared with etanercept, according to a study.

The study used data from the French national health data system database. A total of 16,793 new users of IL17i (mean age 48.4 years, 46 percent men), 20,556 new users of apremilast (mean age 52.5 years, 53 percent men), and 10,245 new users of etanercept (mean age 46.3 years, 44 percent men) comprised the study population.

Previous systemic treatments were somewhat similar between the IL17i and etanercept groups compared with apremilast. The primary endpoint of IBD occurred in 132 individuals overall. The incidence did not differ across the three groups: 72 (0.43 percent) IL17i new-users, 11 (0.05 percent) apremilast new-users, and 49 (0.48 percent) etanercept new-users. Most IBD cases occurred after 6 months of treatment (82 percent, 55 percent, and 76 percent, respectively).

In a time-to-event analysis with propensity score-weighted Cox and Fine-Gray models, the risk of IBD in the IL17i group was comparable with that in the etanercept group (hazard ratio [HR], 0.8, 95 percent confidence interval [CI], 0.5–1.2) but significantly higher than in the apremilast group (HR, 3.8, 95 percent CI, 2.1–6.8).

The findings should be confirmed in other large databases.