Psoriasis and IBD — SCE Dermatology MCQ

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EasyDermatopharmacologyPsoriasis and IBDSCE Dermatology

A 40-year-old woman with chronic plaque psoriasis has co-existing Crohn disease. Her gastroenterologist wants to start a biologic that treats both conditions. However, one biologic class is specifically contraindicated in IBD. Which class should be AVOIDED?

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Correct answer: B — IL-17 inhibitors (Secukinumab, Ixekizumab, Brodalumab) — can trigger or exacerbate IBD

IL-17 inhibitors are relatively contraindicated in patients with active or known inflammatory bowel disease. Clinical trial data and post-marketing surveillance have shown new-onset or exacerbation of Crohn disease and ulcerative colitis in patients treated with IL-17 inhibitors for psoriasis. The mechanism relates to the protective role of IL-17 in intestinal mucosal immunity. Appropriate biologic choices for concurrent psoriasis and IBD include: TNF-alpha inhibitors (Adalimumab, Infliximab — approved for both conditions), Ustekinumab (IL-12/23 — approved for both), and Risankizumab (selective IL-23 — now approved for Crohn). This is a critical prescribing consideration that frequently appears in clinical practice and examinations.

Reference: BAD 2020 Biologic Guidelines; NICE IBD/Psoriasis