Risiko für Infektion bei Psoriasis unter Interleukin-23- und Interleukin-17-Inhibitoren?

Ausserdem widmen wir uns der Lebenserwartung beim Stevens-Johnson-Syndrom und dem Zusammenhang zwischen Januskinase-Hemmern und unerwünschten Ereignissen bei Akne vulgaris.

Evaluating the risk of infections under interleukin 23 and interleukin 17 inhibitors relative to tumour necrosis factor inhibitors – a population-based study

Biologics targeting key cytokines driving inflammatory diseases have shown some success in controlling psoriasis. Due to the immunosuppressive nature of these drugs, their use is potentially associated with increased risks of infections. Kridin et al. compared the risk of infectious complications in patients with psoriasis undergoing treatment with interleukin (IL)-23 inhibitors (IL-23i) and IL-17 inhibitors (IL-17i) against tumor necrosis factor inhibitors (TNFi) in a global cohort study.

They found that patients on IL-23i had a lower risk of various infections, including otitis media, encephalitis, herpes zoster, hepatitis B virus reactivation, cytomegalovirus, influenza, and parasitic diseases. Similarly, IL-17i was associated with a decreased risk of pneumonia, septicaemia, upper respiratory tract infection, herpes zoster, hepatitis B and C virus reactivation, cytomegalovirus, Epstein–Barr virus, influenza, and parasitic diseases compared to TNFi, suggesting that IL-23i and IL-17i have a high safety profile and may be preferred in patients with susceptibility to infections.

Lifetime risk, life expectancy, loss-of-life expectancy and lifetime healthcare expenditure for Stevens–Johnson syndrome/toxic epidermal necrolysis in Taiwan – follow-up of a nationwide cohort from 2008 to 2019

Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) presents a persistent health burden, with a reduced lifetime risk in Taiwan between 2008 and 2019 due to HLA-B*15:02 screening and reduced prescriptions. Despite this improvement, individuals with SJS/TEN still experience a notable 9.43-year reduction in life expectancy, attributed to increased mortality and enduring effects. The study underscores heightened loss of life expectancy and healthcare expenses for males, those with comorbidities, sequelae, or intensive care/burn unit admissions, underscoring the long-term burden faced by younger SJS/TEN patients and the necessity for targeted resource allocation and effective strategies.

Janus kinase inhibitors and adverse events of acne — a systematic review and meta-analysis

The JAK-STAT pathway plays a crucial role in inflammatory conditions, and JAK inhibitors are emerging as treatments for dermatologic, hematologic, and rheumatologic disorders. Eight FDA-approved medications target JAK proteins, but acne is a common adverse effect in clinical trials, with little known about its overall incidence and variations between drug classes and treated conditions. A systematic review and meta-analysis were conducted to analyze the risk of acne associated with JAK inhibitors using published phase 2 and 3 placebo-controlled randomized clinical trials. These data demonstrate the significant increases in incidence of acne associated with combined JAK1 and JAK2 inhibitors, JAK1 inhibitors, as well as the TYK2 inhibitor deucravacitinib. Pan-JAK inhibitors and the JAK3-specific inhibitor ritlecitinib do not appear to be associated with incident acne; however, analysis of the effects of TYK2 inhibitors and ritlecitinib should be interpreted cautiously given the imprecision of the effect estimates and small sample sizes.