Expert Opinion on Pharmacotherapy, Год журнала: 2023, Номер 24(18), С. 2153 - 2159
Опубликована: Ноя. 29, 2023
Introduction New biologic and small molecule therapeutics have emerged for the treatment of moderate-to-severe atopic dermatitis (AD), including oral Janus kinase (JAK) inhibitors such as baricitinib. While JAK are commonly used to treat rheumatoid arthritis inflammatory bowel disease, these agents relatively new in field dermatology.
Язык: Английский
Dermatology and Therapy, Год журнала: 2024, Номер 14(4), С. 919 - 932
Опубликована: Март 21, 2024
Several systemic therapies have been approved for the treatment of severe AD. In particular, Janus kinase inhibitors (JAKi), including abrocitinib, baricitinib, and upadacitinib, recently received approval patients with AD after being evaluated in several clinical trials. However, a few concerns raised regarding their long-term safety management these drugs real-world practice. this article we described results Delphi consensus aimed at describing knowledge on JAKi focusing, providing recommendations dermatologists daily practice use drugs. Twelve Italian reviewed most recent literature efficacy profiles proposed 24 statements. Agreement was reached statements focusing three main topics: (1) place therapy moderate-to-severe AD; (2) effectiveness JAK different phenotypes; (3) approaches to treated The panel all Given wide practice, it is crucial establish specific follow-up each patient's phenotype order achieve best possible outcome minimize potential adverse events.
Язык: Английский
Процитировано
18
Clinical Therapeutics, Год журнала: 2025, Номер unknown
Опубликована: Фев. 1, 2025
To compare the risk of cardiovascular disease (CVD) and common solid cancers between JAK inhibitors (JAKi) versus TNF or IL-17 inhibitors, among people with psoriatic arthritis (PsA) axial spondyloarthritis (axSpA). We used real-world electronic health records data from a predominantly North American population PsA axSpA. Initiators JAKi (tofacitinib upadacitinib) TNFi were 1:1 propensity score matched. Cox models to time CVD (acute myocardial infarction, stroke revascularization) (breast, colorectal, lung prostate) over 3 years. Analyses repeated for IL-17i. performed sensitivity analyses follow-up 1 5 years, in those aged ≥65 initiating treatment before 2021. The vs comparison included 2,200 matched individuals each group 3,092 4,618 person-years, respectively. Compared TNFi, was not associated higher (HR 0.977; 95% 0.632, 1.510) cancer 0.710; 0.462, 1.091) years' follow-up. IL-17i 2,287 3,190 4,312 IL-17i, 1.114; 0.720,1.722) 0.737; 0.484,1.122). Results across stratified directionally concordant. These results are reassuring that large axSpA, increased cancers, compared initiators. Ongoing monitoring risks is needed.
Язык: Английский
Процитировано
2
Journal of Allergy and Clinical Immunology, Год журнала: 2024, Номер 154(5), С. 1195 - 1203.e3
Опубликована: Авг. 7, 2024
Язык: Английский
Процитировано
8
Current Allergy and Asthma Reports, Год журнала: 2024, Номер 24(5), С. 289 - 301
Опубликована: Апрель 18, 2024
Historically, systemic treatments for atopic dermatitis (AD) primarily consisted of immunosuppressive agents such as corticosteroids and Disease Modifying Antirheumatic Drugs (DMARDS), which provided symptomatic relief but often had long-term adverse effects. Newer have shown significant efficacy with less side effects in clinical trials. This review discusses compares conventional newer AD.
Язык: Английский
Процитировано
4
eJHaem, Год журнала: 2025, Номер 6(1)
Опубликована: Фев. 1, 2025
ABSTRACT Background Janus kinase inhibitors (JAKis) are an integral aspect of the management myeloproliferative neoplasms (MPNs). Part clinical benefit derived from JAKis may be due to reductions in thrombosis, a potentially life‐threatening complication MPNs. However, evidence has emerged adverse cardiovascular effects secondary JAKis. We conducted first‐of‐a‐kind meta‐analysis safety treatment Methods This study was according Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA). searches studies comparing JAKi control group were conducted. Studies reporting hypertension, major events (MACE) thromboembolic included using random‐effects model primary analysis, fixed‐effects any subgroup analyses performed. Results A total 23 publications, consisting nine trials one retrospective met inclusion criteria. resulted pooled population 2198 patients (JAKi n = 1145, Control 1053). In ( 9), analysis revealed significantly lower rate (incidence ratio (IRR): 0.52, 95% CI: 0.28–0.98, p 0.04). primarily driven by ruxolitinib myelofibrosis (MF) polycythemia vera (PV) as when these performed 7), even more significant reduction with found (IRR: 0.41, 95%CI: 0.26–0.64, < 0.001). There no difference MACE or hypertension between groups. Conclusion suggests that MPN associated reduced risk events; PV MF. Further prospective warranted confirm findings characterise profile other types
Язык: Английский
Процитировано
0
International Journal of Dermatology, Год журнала: 2025, Номер unknown
Опубликована: Апрель 28, 2025
Язык: Английский
Процитировано
0
Frontiers in Immunology, Год журнала: 2024, Номер 15
Опубликована: Фев. 23, 2024
Background Clinicians and healthcare policymakers have been drenched with a deluge of overlapping meta-analyses (MAs), the necessity for comprehensive clearly defined evidence Janus kinase inhibitors (JKIs) in atopic dermatitis (AD) is urgent. Methods Six databases were searched MAs published until October 2023. Qualitative description was mainly used, Investigator's Global Assessment response (IGA response), 75% improvement Eczema Area Severity Index (the EASI75), peak pruritus Numerical rating score (PP-NRS), adverse effects cited to describe efficacy safety JKIs. The methodological quality included assessed by A Measurement Tool Assess Systematic Reviews II (AMSTAR II), evaluated grading recommendations, assessment, development, evaluation (GRADE). Results Sixteen pooled this review, which five studies appraised JKIs, systemic papers abrocitinib only, one baricitinib. Two “high” 14 “moderate” quality. Eleven integrated results JKIs reported that provide faster onset IGA (RR=2.83, 95% CI [2.25, 3.56], high-quality evidence). Similarly, 10 showed JAK more effective improving EASI75 (RR=2.84, [2.2, 3.67], from 12 active reducing PP-NRS (SMD=-0.49, [-0.67, -0.32]). All affirmed added no leading discontinuation serious events (P<0.05). However, 200mg had higher risk acne (RR=4.34, [1.61, 11.71), herpes zoster (RR=1.64, [0.42, 6.39]), headache (RR=1.76, [1.03, 3]), nausea (RR=7.81, [3.84, 15.87]). Upadacitinib known increase (RR=6.23, [4.08, 9.49]), nasopharyngitis (RR=1.36, 1.8]) blood creatine phosphokinase (blood CPK) (RR=2.41, [1.47, 3.95]). Baricitinib at 2mg associated increased CPK (RR=2.25, [1.1, 2.97]). Conclusion Compared placebo or dupilumab, administration can ameliorate effectively, improve EASI75, relieve without severe effect, while accompanied acne, nasopharyngitis, headache, digestive disturbances. curative effect 200 mg significant caution should be given patients gastrointestinal dysfunction, zoster, those who are acne-prone. upadacitinib avoided populations high cardiovascular events. review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=369369 , PROSPERO (CRD42022369369).
Язык: Английский
Процитировано
3
Clinical and Experimental Dermatology, Год журнала: 2024, Номер 49(11), С. 1405 - 1412
Опубликована: Май 4, 2024
Abstract Background Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease characterized by intense itch, and impacting heavily on patients’ caregivers’ quality of life. Its clinical presentation accompanied variety comorbidities associated with type 2 inflammation, such as asthma, hay fever food allergies. However, current data cardiovascular are inconsistent. Objectives To identify the risk diseases (CVDs) in patients AD. Methods Data from electronic health records 1 070 965 AD equally distributed propensity-score matched controls were retrieved US Collaborative Network, part federated TriNetX network. Hazard ratios (HRs) for onset CVDs prevalence ≥ 1% both cohorts within 20 years after diagnosis determined. Results In total, 55 belonging to 8 major groups identified. Of those, 53 diagnoses displayed significantly increased Different heart failure found most often, followed valve insufficiencies, arrhythmia, tachycardia, atrial fibrillation flutter, but also adverse events venous thromboembolism. The highest HRs individual insufficiency, atherosclerosis native arteries extremities, unspecified diastolic (congestive) failure. Conclusions an multiple CVDs.
Язык: Английский
Процитировано
3
Lasers in Medical Science, Год журнала: 2024, Номер 39(1)
Опубликована: Май 25, 2024
Язык: Английский
Процитировано
3
Biomedicines, Год журнала: 2023, Номер 11(8), С. 2284 - 2284
Опубликована: Авг. 17, 2023
Inflammation has a critical role in the development and progression of atherosclerosis. On molecular level, inflammatory pathways negatively impact endothelial barrier properties thus, tissue homeostasis. Conformational changes destruction glycocalyx further promote pro-inflammatory also contributing to pro-coagulability prothrombotic state. In addition, extracellular matrix composition lead (peri-)vascular remodelling alterations vessel wall, e.g., aneurysm formation. Moreover, progressive fibrosis leads reduced perfusion due loss functional capillaries. The present review aims at discussing clinical effects processes on micro- macrovasculature with focus peripheral artery disease.
Язык: Английский
Процитировано
8