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TOPLINE
A meta-analysis found that interleukin-17 (IL-17) inhibitors were not associated with a significantly increased risk for new-onset inflammatory bowel disease (IBD) in patients with hidradenitis suppurativa (HS) compared with placebo, though nonrandomized studies showed higher event rates.
METHODOLOGY
- Researchers conducted a systematic review and meta-analysis of 24 studies (10 randomized clinical trials [RCTs], 11 nonrandomized studies, and three case reports) evaluating IBD outcomes in patients with HS who were treated with IL-17 inhibitors from inception through November 2025.
- A total of 3015 patients received IL-17 inhibitors (bimekizumab, secukinumab, sonelokimab, and izokibep) and 1066 patients received placebo in the RCTs. The mean age was 36.8 years and 54.3% were women.
- Primary outcome was IBD event, defined as new-onset or worsening Crohn's disease or ulcerative colitis during IL-17 inhibitor treatment.
TAKEAWAY
- Across all randomized trials, long-term extension studies, and nonrandomized studies, 17 new-onset cases and four flares of IBD were reported; of these, seven occurred within the first 6 months of therapy and eight between weeks 16 and 52.
- In RCTs, new-onset IBD occurred in 0.23% of patients treated with IL-17 inhibitors and in none treated with placebo through week 16, with no significant difference between groups.
- Between weeks 16 and 52 in RCTs, three new-onset IBD events occurred among 1921 patients exposed to IL-17 inhibitor therapy, with a crude incidence of 0.16% and a pooled incidence of 0.3%.
- In nonrandomized studies, seven new-onset IBD events occurred among 469 patients, with a crude incidence of 1.49% and a pooled incidence of 3.9%.
IN PRACTICE
"In this systematic review and meta-analysis, IBD events observed during IL-17 inhibitor therapy for HS were rare in clinical trials as well as nonrandomized studies," the authors wrote. "Although the absolute risk appears low, interpretation is constrained by the low events and inconsistent reporting of IBD outcomes and baseline status," they added and called for "[i]mproved standardization in reporting of IBD" for "better estimate risk and strengthen the interpretation of safety data."
SOURCE
The study was led by Marley Cutrona, BS, Icahn School of Medicine, Mount Sinai, New York. It was published online on September 9 in JAMA Dermatology.
LIMITATIONS
The overall number of IBD events was small. IBD was not a primary endpoint in most included studies, and baseline IBD and family history were frequently unreported. Follow-up duration and dosing regimens varied among studies. Additionally, the study population included only adult patients.
DISCLOSURES
The authors did not report any funding information. One author reported receiving institutional funding, consulting fees, and speaker fees from multiple pharmaceutical companies including Eli Lilly, Incyte, Johnson & Johnson, Novartis, and Merck. Additional disclosures are reported in the original article.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
