Objectives

Anti-IL-17/23 biologics are increasingly used to treat psoriasis. We aimed to elucidate characteristics of drug-induced interstitial pneumonia (DIIP) caused by anti-IL-17/23 biologics.

Methods

We retrospectively analyzed the clinical data of psoriasis patients treated with anti-IL-17/23 biologics. Chest CT was performed to evaluate DIIP. Serum KL-6 levels were measured before treatment (baseline) and during treatment.

Results

A total of 603 psoriasis patients were treated with anti-IL-17/23 biologics with mean follow-up of 21.1 months. Six patients developed DIIP at mean 14 months after initiation of the therapy. Older age, higher baseline KL-6 value and more frequent pre-existing IPs were associated with development of DIIP by univariate analysis. At the onset of DIIP, elevated serum KL-6 levels with concomitantly increased ground glass opacity (GGO) in Chest CT were demonstrated. DIIP was improved by only cessation of causative agents in five patients but steroid therapy was needed in one patient.

Conclusions

DIIP is a plausible complication of anti-IL-17/23 biologics. Age, baseline KL-6 level and underlying IP could be the risk factors for DIIP development. Serum KL-6 levels and chest CT are useful for not only predicting but also detecting DIIP caused by anti-IL-17/23 biologics.

中文翻译：

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银屑病患者抗IL-17 / 23生物制剂引起的间质性肺炎的特征

目标

抗IL-17 / 23生物制剂越来越多地用于治疗牛皮癣。我们旨在阐明由抗IL-17 / 23生物制剂引起的药物性间质性肺炎（DIIP）的特征。

方法

我们回顾性分析了抗IL-17 / 23生物制剂治疗的牛皮癣患者的临床数据。进行胸部CT检查以评估DIIP。在治疗前（基线）和治疗期间测量血清KL-6水平。

结果

总共603例牛皮癣患者接受了抗IL-17 / 23生物制剂治疗，平均随访21.1个月。6名患者在开始治疗后平均14个月出现DIIP。单因素分析表明，年龄较大，基线KL-6值较高和IP频率较高与DIIP的发生有关。在DIIP发作时，胸部CT显示血清KL-6水平升高，同时伴有毛玻璃浊度（GGO）升高。仅在5例患者中停止使用病原体即可改善DIIP，但在1例患者中需要类固醇治疗。

结论

DIIP是抗IL-17 / 23生物制剂的合理并发症。年龄，基线KL-6水平和基本IP可能是DIIP发展的危险因素。血清KL-6水平和胸部CT不仅可用于预测而且还可检测由抗IL-17 / 23生物制剂引起的DIIP。