Reply: comment on: Risk of inflammatory bowel disease in patients with psoriasis, psoriatic arthritis and ankylosing spondylitis initiating interleukin 17 inhibitors.

We appreciate the comments from Dr. Cheng-Ruei Yang et al. about our recent article that investigated whether IL17-inhibitors (IL17i) initiation is associated with a higher risk of inflammatory bowel disease (IBD) in patients with psoriasis (PsO), psoriatic arthritis and ankylosing spondylitis (PsA/AS).(1) We demonstrated that treatment with IL17i was not associated with a higher risk of IBD in patients with PsO, or PsA/AS when taking into account the severity of the underlying disease i.e. when using etanercept as a comparator. The main strength of this study was the use of a large sample from a nationally representative database, the French national health data system (Système National des Données de Santé [SNDS]) which has contained comprehensive data on all reimbursements for health-related expenditures, on ambulatory care and hospitalizations since 2006.(2,3).