Risk of multiple sclerosis in patients with psoriasis receiving anti-IL-17 agents: A case-based review

Abstract

Biologics approved for psoriasis exhibit favorable safety profiles, and serious adverse events have rarely been reported. In this report, we present the case of a patient treated with ixekizumab, an anti-interleukin (IL)-17 agent, who 8 months later developed multiple sclerosis (MS). We also review the available literature regarding the use of anti-IL-17 agents in the context of psoriasis and pre-existing or new-onset demyelination. Eight case reports were evaluated as relevant and are presented in our report. In most of the cases secukinumab or ixekizumab administration adequately controlled both skin and pre-existing neurological clinical manifestations. However, there has been a report of MS exacerbation under secukinumab treatment and the occurrence of myelitis in a patient receiving ixekizumab. While the anti-IL-17-biologic-mediated induction of inflammatory events in the central nervous system has not been proven and a causal relationship is lacking, such a probability should be considered in extremely rare cases.

Keywords: MS; anti‐IL‐17; demyelination; psoriasis.

FIGURE 1

Magnetic resonance imaging of the spinal cord and the brain of the patient. (a) Hyperintense lesions are detected on both the cervical and the thoracic spine. (b) Periventricular lesion detected on the brain scans.