Low Risk of Latent TB with Secukinumab Save
TB reactivation and latent tuberculosis infection (LTBI) are warned against with biologic agents, especially TNF inhibitors; yet clinical trial data now shows that the risk of LTBI with IL-17 inhibition via secukinumab is uncommon.
Qualitative analysis of 12 319 clinical trial patients with psoriasis, psoriatic arthritis, or ankylosing spondylitis treated with secukinumab or placebo in phase 3 or 2 trials looked at the risk of active TB or LTBI as an adverse event over a 5-year period.
From a total of 12 319 patients, 684 patients (5.6%) had tested positive for LTBI at screening (prior to secukinumab).
Over the next 5 years, LTBI as an AE during secukinumab treatment was reported in 13 patients (0.1% of 12 319). Of these 13 patients, 6 had a prior positive LTBI test result, and 7 were newly diagnosed as having LTBI. No cases of active TB were reported.
These data suggest a vey low risk of LTBI with secukinumab, roughly a 1 in 1000 risk; nevertheless the product label calls for pretreatment TB screening.
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The author has no conflicts of interest to disclose related to this subject
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