A90 THREE PATIENTS WITH INFLAMMATORY BOWEL DISEASE DIAGNOSED WHILE BEING TREATED WITH SECUKINUMAB FOR PSORIASIS
Notice bibliographique
Résumé
We report three cases of inflammatory bowel disease (IBD) in patients on secukinumab, an anti-IL-17A antibody, for psoriasis. Case Review Patient one: 49 year old female, with a history of psoriasis managed with secukinumab, presented to hospital with a six-day history of bloody diarrhea. C-reactive protein was >190 mg/L and erythrocyte sedimentation rate was 70 mm/hr. Colonoscopy showed severe colitis. Pathology showed cryptitis, crypt abscesses, crypt architectural irregularity, without granulomatous lesions. She was started on intravenous steroids during her hospitalization and on infliximab for maintenance IBD therapy. Her secukinumab was discontinued. Patient two: 54 year old male with psoriasis that was managed with secukinumab. The patient developed symptoms of diarrhea, occurring 6–7 times per day, shortly after secukinumab exposure. Colonoscopy showed severe pancolitis. Histology showed patchy chronic inflammation, consistent with IBD. He was started on adalimumab and methotrexate therapy, and achieved clinical remission. Secukinumab was discontinued. Patient three: 28 year old male on secukinumab therapy for his psoriasis with good clinical response. Shortly after starting secukinumab he developed diarrhea symptoms, having 3–4 loose bowel movements per day. Fecal calprotectin was elevated at 563.8 mg/kg. Colonoscopy and histology showed colonic mucosa with focal active cryptitis and non-necrotizing granulomas. Secukinumab was discontinued and he was started on ustekinumab for his psoriasis, with clinical response. The role of secukinumab in Crohn’s disease has been investigated in a randomised double-blind placebo-controlled trial, which showed IL-17A blockade was not effective in the treatment of Crohn’s disease and resulted in more adverse events when compared to placebo (Hueber et al). In this study, six severe drug-related adverse events were reported in the secukinumab group and one such event in the placebo group; five of these events were worsening of Crohn’s disease. The current evidence suggests that IL-17A blockade is efficacious in psoriasis. A pooled analysis of ten phase II and III studies in patients with plaque psoriasis showed an overall favorable safety profile. In this analysis, three cases of Crohn’s disease were reported among individuals on secukinumab (Malakouti et al). Our cases of inflammatory bowel disease diagnosed in three patients on secukinumab for psoriasis highlight the complex and multifaceted role of the Th17 pathway. The Th17 inflammatory response can be either protective or exacerbating depending on the organ system involved. None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».