Risk of Oral Complications Among IL-17 Inhibitor Users: A Systematic Review and Meta-Analysis.

BACKGROUND

IL-17 inhibitors are increasingly used in dermatologic and autoimmune diseases, yet the risks of associated oral complications remain unclear.

METHODS

PubMed, Embase, Web of Science, and ClinicalTrials.gov were comprehensively searched. The primary outcome was the incidence of oral complications following IL-17 inhibitors therapy. A meta-analysis was conducted using random-effects models.

RESULTS

A total of 106 clinical trials involving 57,017 participants were included. Oral mucosal infections were the most frequently observed complications. Meta-analysis was performed to evaluate the incidence of oral candidiasis and oral herpes, showing the pooled incidence of 4.73% (95% CI: 3.42-6.22) and 2.94% (95% CI: 2.50-3.42), respectively. Subgroup analysis indicated a higher risk of oral candidiasis with bimekizumab compared to secukinumab. Notably, the meta-analysis for oral candidiasis demonstrated high heterogeneity (I2 = 93.8%). Besides, bacterial odontogenic diseases (dental caries, pulpitis, abscesses, gingivitis, and periodontitis) and neuropathic disorders (trigeminal neuralgia and facial paralysis), neoplasm (lip neoplasms and tongue squamous cell carcinoma), were reported more frequently in IL-17 inhibitors users.

CONCLUSION

IL-17 inhibitor administration is associated with an elevated incidence of oral complications, particularly oral candidiasis and herpetic infections, highlighting the importance of clinician awareness and assessment of oral complications during IL-17 inhibitors therapy.