Risk of candidiasis associated with interleukin-17 inhibitors: A real-world observational study of multiple independent sources.
Candidiasis
Drug safety
IL-12/23 inhibitors
IL-17 inhibitors
Pharmacovigilance
ixekizumab
secukinumab
ustekinumab
Journal
The Lancet regional health. Europe
ISSN: 2666-7762
Titre abrégé: Lancet Reg Health Eur
Pays: England
ID NLM: 101777707
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
entrez:
24
12
2021
pubmed:
25
12
2021
medline:
25
12
2021
Statut:
epublish
Résumé
Biologics directed against the T-helper (Th)-17 pathway have been approved for several inflammatory diseases. Interleukin (IL)-17 is involved in anti- A comprehensive analysis of multiple independent sources reporting A strong association between IL-17 inhibitors and candidiasis (ROR 10·20) was found in the WHO database, particularly for cutaneous (ROR 12·28), oropharyngeal (ROR 19·18), and esophageal candidiasis (ROR 21·20). Risk was higher relative to TNF-α inhibitors (4-10-fold, depending on candidiasis type), confirmed by EMA reports (16-33-fold), prescriptions registry (2-42-fold), and a psoriasis cohort (3-25-fold). After start of IL-17 inhibitors, patients' risk of candidiasis requiring antifungals increased 2-16 fold. In the psoriasis cohort, 58% of IL-17 treatment episodes were associated with candidiasis. In Th17 inhibitor recipients, proteins involved in anti- IL-17 inhibitors are associated with an increased risk of oropharyngeal, esophageal, and cutaneous candidiasis, posing a significant disease burden for IL-17 inhibitor recipients. RadboudUMC.
Sections du résumé
BACKGROUND
BACKGROUND
Biologics directed against the T-helper (Th)-17 pathway have been approved for several inflammatory diseases. Interleukin (IL)-17 is involved in anti-
METHODS
METHODS
A comprehensive analysis of multiple independent sources reporting
FINDINGS
RESULTS
A strong association between IL-17 inhibitors and candidiasis (ROR 10·20) was found in the WHO database, particularly for cutaneous (ROR 12·28), oropharyngeal (ROR 19·18), and esophageal candidiasis (ROR 21·20). Risk was higher relative to TNF-α inhibitors (4-10-fold, depending on candidiasis type), confirmed by EMA reports (16-33-fold), prescriptions registry (2-42-fold), and a psoriasis cohort (3-25-fold). After start of IL-17 inhibitors, patients' risk of candidiasis requiring antifungals increased 2-16 fold. In the psoriasis cohort, 58% of IL-17 treatment episodes were associated with candidiasis. In Th17 inhibitor recipients, proteins involved in anti-
INTERPRETATION
CONCLUSIONS
IL-17 inhibitors are associated with an increased risk of oropharyngeal, esophageal, and cutaneous candidiasis, posing a significant disease burden for IL-17 inhibitor recipients.
FUNDING
BACKGROUND
RadboudUMC.
Identifiants
pubmed: 34950923
doi: 10.1016/j.lanepe.2021.100266
pii: S2666-7762(21)00252-0
pmc: PMC8671639
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100266Informations de copyright
© 2021 The Author(s).
Déclaration de conflit d'intérêts
J.M.P.A. van den Reek carried out clinical trials for AbbVie, Celgene and Janssen and has received speaking fees/attended advisory boards from AbbVie, Janssen, BMS, Almirall, Leo Pharma and Eli Lilly and reimbursement for attending a symposium from Janssen, Pfizer, Celgene and AbbVie. All funding is not personal but goes to the independent research fund of the department of dermatology of Radboud university medical centre Nijmegen, the Netherlands. E.M.G.J. de Jong received grants from ZonMw, AbbVie, Janssen, Novartis, Pfizer, and Leo Pharma outside the submitted work. E.M.G.J. de Jong received research grants from the independent research fund of the Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands and acts as a consultant and/or paid speaker for and/or participating in research sponsored by AbbVie, Janssen, Novartis, Eli Lilly and Company, Celgene, and Leo Pharma.
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