SpA with IBD — SCE Rheumatology MCQ

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ModerateSpondyloarthropathySpA with IBDSCE Rheumatology

A 35-year-old man with AS develops inflammatory bowel disease. He is currently on Secukinumab for his axSpA. His gastroenterologist diagnoses Crohn disease. What medication change is most appropriate?

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Correct answer: A — Switch from Secukinumab to Adalimumab or Infliximab

IL-17 inhibitors (Secukinumab Ixekizumab) can exacerbate or trigger IBD and should be avoided in patients with active IBD. Monoclonal anti-TNF antibodies (Adalimumab Infliximab) are effective for both axSpA and Crohn disease making them the optimal choice for this patient. BSR 2025 axSpA guidelines specifically recommend considering concomitant IBD when selecting targeted therapy and advising against IL-17 inhibitors in this context. Switching to a monoclonal anti-TNF addresses both conditions with a single agent.

Reference: BSR 2025 axSpA guidelines; ECCO IBD guidelines