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| 題 名 | Rapid-onset de Novo Crohn's Disease following Ixekizumab Therapy in Patient with Chronic Plaque Psoriasis: A Case Report and Literature Review=使用Ixekizumab後快速發生克隆氏症的斑塊型乾癬病人病例報告 |
|---|---|
| 作 者 | 黃敬雯; 黃書瀚; 朱宮瑤; | 書刊名 | 輔仁醫學期刊 |
| 卷 期 | 23:3 2025.09[民114.09] |
| 頁 次 | 頁40-44 |
| 分類號 | 415.731 |
| 關鍵詞 | 乾癬; 克隆氏症; 生物製劑; Psoriasis; Crohn's disease; Biologics; Ixekizumab; IL-17; |
| 語 文 | 英文(English) |
| DOI | 10.53106/181020932025092303004 |
| 中文摘要 | 乾癬是慢性發炎的皮膚疾病,生物製劑為近代廣泛使用的治療。Ixekizumab為一種單株抗體,是針對與乾癬致病機轉的IL-17開發的藥物,已經核准並且用於臨床。在2024年一篇長期安全性報告中,有提及此藥物可能會誘發發炎性腸道疾病,雖然發生率極低,潰瘍性結腸炎為千分之三,克隆氏症為千分之二,但是依然值得注意。發炎性腸道疾病在亞洲族群發生率是低於歐美族群,並且此藥物在臨床實驗時,納入的亞洲族群日本人並無任何人罹病。但是我們以Ixekizumab治療一名28歲無任何過去病史及家族史的乾癬病人後,卻產生克隆氏症,其發生速度快,依仿單使用在第二劑施打完二天,就發生血便腹痛症狀,經大腸鏡檢查並切片證實,病人也在馬上停藥治療後,一周後緩解,七個月皆無復發,此一罕見使用Ixekizumab後快速發生克隆氏症病例報告,顯示臨床醫師早期發現,早期治療期,可獲得良好預後。 |
| 英文摘要 | Psoriasis is a chronic inflammatory dermatosis. Ixekizumab is a monoclonal antibody that targets interleukin 17A (IL-17A) and indicated for plaque psoriasis. In 2024, a study analyzed the long-term safety of ixekizumab in patients with psoriasis(6892 cases) and identified 31 cases of inflammatory bowel disease (IBD; 0.5%, incidence rate 0.2 per 100 PY), of which 18 were cases of ulcerative colitis (0.3%, incidence rate 0.1 per 100 PY) and 13 of Crohn's disease (CD; 0.2%, incidence rate 0.7 per 100 PY). However, subgroup analysis of Japanese patients in a phase III study on ixekizumab uncovered no cases of IBD. The literature suggest that CD following ixekizumab therapy is uncommon, especially in Asian patients. Herein, we report the case of a Taiwanese patient who developed rapid-onset de novo CD following ixekizumab therapy for chronic plaque psoriasis. Ixekizumab therapy was administered as per the instruction sheet, and his symptoms appeared 2 days following the 2nd dose of ixekizumab. Due to the rarity, we report this case to highlight the importance of adverse event. Early detection and diagnosis result in a good outcome. Physicians should be alert to its possibility. Careful history taking of gastrointestinal symptoms is recommended before and after anti-IL-17 therapy. |
本系統中英文摘要資訊取自各篇刊載內容。