PLoS ONE (Jan 2021)

Characteristics of anti-IL-17/23 biologics-induced interstitial pneumonia in patients with psoriasis.

  • Hanae Miyagawa,
  • Hiromichi Hara,
  • Jun Araya,
  • Shunsuke Minagawa,
  • Takanori Numata,
  • Yoshinori Umezawa,
  • Akihiko Asahina,
  • Hidemi Nakagawa,
  • Kazuyoshi Kuwano

DOI
https://doi.org/10.1371/journal.pone.0245284
Journal volume & issue
Vol. 16, no. 1
p. e0245284

Abstract

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ObjectivesAnti-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.MethodsWe 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.ResultsA 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.ConclusionsDIIP 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.