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Kidney Week

Abstract: PO2395

Treatment with IL-17 Inhibitors Is Associated with Reduced eGFR in Patients with Psoriasis or Psoriatic Arthritis: A Retrospective Cohort Study

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Tsai, Peihsuan R., University of Rochester Medical Center, Rochester, New York, United States
  • Gilroy, Daniel X., Rochester Institute of Technology, Rochester, New York, United States
  • Le, Thu H., University of Rochester Medical Center, Rochester, New York, United States
  • Drury, Erika, University of Rochester Medical Center, Rochester, New York, United States
Background

The complex interplay of the cytokines within the IL family can both mediate and modulate inflammation. Specifically, the cytokine IL-17 has been implicated in several disease processes including hypertension, cardiovascular, autoimmune, and chronic inflammatory diseases. However, there is emerging evidence that IL-17 can also favorably modulate inflammation. It has been demonstrated that low-dose IL-17 therapy may prevent and reverse diabetic nephropathy in mouse models. We aimed to study the effect of IL-17 inhibitors on eGFR in human subjects.

Methods

We conducted a single-center retrospective cohort study of patients who had been treated with an IL-17 inhibitor (ixekuzumab or secukinumab), for the treatment of psoriasis (P) or psoriatic arthritis (PA). Demographics and serum creatinine values were extracted from the electronic medical record. Aggregated data in a 6 month window at 6-months prior to initiation of the IL-17 inhibitor and 12 months after initiation of the IL-17 inhibitor were analyzed using paired t-test. Estimated GFR was calculated using the CKD-Epi equation.

Results

We identified 307 patients who had been treated with IL-17 inhibitors. We included 65 patients who had serum creatinine values at pre-specified time periods before and after initiation of treatment. At baseline, the mean age was 50.3±12 years, 43% were men, 51(78%) had a diagnosis of hypertension, 11(17%) had a diagnosis of diabetes, and mean eGFR was 83.6 mL/minute/1.73 m2. One year after initiation of IL-17 inhibitor therapy, mean eGFR was significantly lower at 78.7 mL/minute/1.73 m2 (p < 0.001). After excluding patients taking medications known to affect eGFR (n=26), there was still a significant decrease in eGFR after 1 year (88.4 versus 83.2 ml/minute/1.73 m2, p < 0.01).

Conclusion

In patients with P or PA, IL-17 inhibitor therapy is associated with a reduction in eGFR at 1 year after initiation of treatment. Prospective study with longer follow-up is needed to determine the long-term effect of IL-17 inhibitor therapy on kidney function.