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IL-17i and IBD Risk — RACP Adult Medicine MCQ

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HardRheumatologyIL-17i and IBD RiskRACP Adult Medicine

A patient taking secukinumab for psoriatic arthritis develops new bloody diarrhoea and colonoscopy confirms Crohn disease. What is the key treatment implication?

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Correct answer: EStop the IL-17 inhibitor and coordinate a therapy effective for both arthritis and inflammatory bowel disease

The best answer is “Stop the IL-17 inhibitor and coordinate a therapy effective for both arthritis and inflammatory bowel disease”. IL-17 inhibition can trigger or exacerbate inflammatory bowel disease and is not used to treat Crohn disease. The drug should be reconsidered with rheumatology and gastroenterology, choosing an alternative—such as an appropriate monoclonal TNF inhibitor, ustekinumab or other agent—according to both diseases and prior treatment. NSAIDs may worsen bowel symptoms.

Reference: Australian Rheumatology Association: Biologic medicines: https://rheumatology.org.au/For-Patients/Adult-Medication-Information Gastroenterological Society of Australia: Clinical practice resources for inflammatory bowel disease: https://gesa.org.au/Web/Resources/Clinical_Practice_Resources.aspx