New-Onset Ulcerative Colitis after Secukinumab Initiation: A Case Report
Bibliographic record
Abstract
Introduction: Secukinumab is an anti-interleukin (IL)-17 used in the treatment of rheumatological conditions such as ankylosing spondylitis and psoriasis. Despite elevated IL-17A levels in inflammatory bowel disease (IBD) patients, clinical trials suggest IL-17 inhibition may exacerbate disease activity in IBD. Multiple sclerosis (MS) also has a suspected association with IBDs. Case Presentation: A 22-year-old man who has a paternal grandfather with a history of MS was started on secukinumab for suspected ankylosing spondylitis. Three months after secukinumab initiation, he developed new gastrointestinal (GI) symptoms and was diagnosed with ulcerative colitis. He responded to a course of corticosteroids, and his secukinumab was stopped. He remains in clinical and endoscopic remission 5 months after completing his course of steroids. Conclusions: This case highlights the potential association between IL-17 inhibition and new-onset IBD in a patient with a family history of MS and illustrates a compelling clinical dilemma regarding the initial selection of biologic therapy in a patient with multiple autoimmune risk factors. Before starting an anti-IL-17 agent, physicians should review the patient's personal and family history of IBD, as well as other risk factors, including immune-mediated conditions such as MS that may increase IBD risk. Patients should then be closely monitored for the development of any new GI symptoms.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".