Characteristically, csDMARDs are not effective in axial involvement and anti-IL-17 or etanercept are contraindicated in active IBD disease.8,15 On the other hand, in severe skin involvement IL-12/23, IL-23, or IL-17 inhibitors are preferred and in co-morbid severe uveitis or IBD, monoclonal antibodies against TNF are highly recommended.16 This evidence concerns the gene IL17A and inflammatory bowel disease.