A systematic review of IL-17 inhibitor use in systemic lupus erythematosus found no reports of new-onset lupus among 13,000 patients across 56 secukinumab trials, with only seven total case reports of lupus following IL-17 inhibitor treatment across all agents.
- Among 13,000 patients in 56 secukinumab trials, zero cases of new-onset lupus were reported
- Only seven case reports exist of lupus developing after starting IL-17 inhibitors across all available drugs
- Four patients with active lupus treated with secukinumab showed variable responses, but data quality was limited
How this compares to prior research
Systemic lupus erythematosus has few licensed treatment options compared to other rheumatic diseases like rheumatoid arthritis and psoriatic arthritis. IL-17 inhibitors are established therapies for psoriasis, psoriatic arthritis, and axial spondyloarthritis, but their role in lupus has been unclear. Prior to this review, concerns existed about whether blocking IL-17 could paradoxically trigger or worsen lupus, while some researchers hypothesized it might offer therapeutic benefit.
Autoimmune disease prevalence trends, global population, 1990–1999
Key findings
- No cases of drug-induced or new-onset SLE were reported in 56 clinical trials of secukinumab involving 13,000 patients
- Seven case reports identified lupus following IL-17 inhibitor initiation: six with secukinumab and one with brodalumab
- Four patients with active SLE treated with secukinumab had heterogeneous outcomes, with 75% treated for cutaneous disease and inflammatory arthritis
What this means in practice
- If you have lupus and another condition requiring IL-17 inhibitors, discuss the low but documented risk of lupus flares with your rheumatologist
- Ask your doctor about standardized disease monitoring if considering IL-17 inhibitors for lupus treatment
- Note that all patients who developed lupus on IL-17 inhibitors recovered after stopping the medication
Frequently asked questions
What are IL-17 inhibitors?
IL-17 inhibitors are monoclonal antibodies that block interleukin-17, a protein involved in inflammation. They are approved for treating psoriasis, psoriatic arthritis, and axial spondyloarthritis.
Can IL-17 inhibitors cause lupus?
Based on this review, the risk appears very low. Among 13,000 patients in secukinumab trials, no new lupus cases were reported. Only seven case reports exist across all IL-17 inhibitors.
Are IL-17 inhibitors effective for treating lupus?
The evidence is insufficient to determine effectiveness. Only four case reports exist of secukinumab use in active lupus, with inconsistent reporting of outcomes and no standardized disease activity measures.
Key terms explained
Interleukin-17 (IL-17)
A protein that promotes inflammation and is involved in autoimmune diseases; blocked by IL-17 inhibitor medications
Systemic lupus erythematosus (SLE)
An autoimmune disease where the immune system attacks multiple organs including skin, joints, kidneys, and other tissues
Paradoxical reaction
An unexpected adverse effect where a medication causes or worsens the condition it is meant to treat or prevent
Source: The role of interleukin-17 inhibition in systemic lupus erythematosus-paradoxical hindrance or new therapeutic potential? Results from a systematic literature review and mendelian randomization. · DOI: doi: 10.3389/fimmu.2026.1706949