Systematic review with meta‐analysis: risk of new onset IBD with the use of anti‐interleukin‐17 agents

Alimentary Pharmacology and Therapeutics - Tập 50 Số 4 - Trang 373-385 - 2019
Akihiro Yamada1,2, Jingzhou Wang3, Yuga Komaki4,2, Fukiko Komaki4,2, Dejan Mićić2, Atsushi Sakuraba2
1Section of Gastroenterology, Department of Internal Medicine, Toho University Sakura Medical Center, Chiba, Japan
2Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine The University of Chicago Medicine Chicago Illinois
3Department of Medicine, The University of Chicago Medicine, Chicago, Illinois
4Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan

Tóm tắt

SummaryBackgroundNew onset IBD has been reported with the use of anti‐IL‐17 agents, but it remains unclear to what extent this is attributed to treatment or to underlying disease.AimTo evaluate the risk of new onset IBD with the use of anti‐IL‐17 agentsMethodsElectronic databases were searched for randomised controlled trials (RCT) of anti‐IL‐17 agents (brodalumab, ixekizumab and secukinumab). Risk of new onset IBD was compared to placebo by Mantel‐Haenszel (MH) risk difference (RD). Sensitivity analyses including meta‐analysis using fixed‐effect model, MH and Peto odds ratio and MH risk ratio were performed due to incidence of rare adverse events. The risk of diarrhoea was also assessed due to the possibility of underdiagnosis of IBD.ResultsThirty‐eight RCTs including 16 690 patients treated with anti‐IL‐17 agents were included. Twelve cases of new onset IBD were reported with anti‐IL‐17 agents in five studies, whereas no cases were reported with placebo. There was no difference in the risk of developing new onset IBD with anti‐IL‐17 agents compared to placebo (MH RD 0.00062, 95% CI −0.00072‐0.0021, P = 0.35). Sensitivity analyses demonstrated no consistent risk with any method. There was no difference in the risk of diarrhoea (MH RD 0.0013, 95% CI −0.0014‐0.0041, P = 0.34).ConclusionsNew onset IBD with the use of anti‐IL‐17 agents was rare. Interpretation of the results needs caution due to the presence of many zero‐event studies.

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Alimentary Pharmacology and Therapeutics

Tập 50 Số 4

373-385

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