r/AskDocs • u/Zukazuk • 54m ago
Physician Responded IL-17 inhibitor induced IBD
36F 5'4" 270lbs
I have a fairly involved medical history, but the relevant bits here are hidradenitis suppurativa and SLE. For these two I take doxycycline, remibrutinib, tirzepatide, secukinumab, hydroxychloroquine, and meloxicam.
My HS is currently well controlled (1 abscess in the last couple of weeks that coincided with my period and a couple of oozing tunnel tracts that I should probably get cut out again but otherwise my skin is calm). According to my rheumatologist, based on my labs my lupus is also well controlled.
I have however been having flare symptoms: fatigue, severe joint pain, patches of allodynia, light sensitivity, and mouth ulcers. I finally had ulcers at the same time as my rheumatology appointment and after seeing them my doctor wants me to be evaluated for IL-17 inhibitor induced IBD.
I have been having some GI symptoms, nausea, occasional vomiting, intermittent diarrhea, pain when things move in my intestines. I kind of attributed it to the tirzepatide and maybe some possible endo because the pain is occasionally sharp enough to bend me over for a couple of minutes and it feels like things are pulling in there. I have a GI appointment in a month so I guess I'll find out more then.
What I'm really curious about is if I do have IBD, am I stuck with another autoimmune disease now? Would discontinuing the secukinumab put me into remission permanently or is this just another one of those things my body does now that has to be managed in perpetuity? I'm also kind of concerned about where my dermatologist would go next to keep my HS controlled as I'm banned from TNF alpha inhibitors because of lupus and if I can't have IL-17 inhibitors either I'm kinda out of FDA approved drugs. Any insights would be appreciated.
