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Infection risk with JAK inhibitors in dermatoses: a meta-analysis
Patrick A Ireland1,2, Matthew Verheyden3,4, Nicholas Jansson5
1Prince of Wales Hospital, Randwick, NSW, Australia.
International Journal of Dermatology
|October 4, 2024
Summary
Janus Kinase Inhibitors (JAKi) show no increased risk for serious or opportunistic infections in dermatologic patients. However, JAK inhibitors are linked to higher rates of varicella-zoster and herpes simplex infections, especially in atopic dermatitis patients.
Area of Science:
- Dermatology and Immunology
- Pharmacology and Therapeutics
Background:
- Janus Kinase Inhibitors (JAKi) are increasingly used for dermatologic conditions.
- Concerns exist regarding JAKi's potential to increase infection risk, including tuberculosis and herpes viruses.
Approach:
- Systematic review and meta-analysis of placebo-controlled randomized trials (inception to June 2023).
- Included studies focused on dermatologic indications for systemic JAKi.
- Analyzed incidence of serious, opportunistic, upper respiratory tract, and specific viral infections (herpes simplex, varicella-zoster, tuberculosis).
Key Points:
- No significant increase in serious (OR: 0.92) or opportunistic infections (OR: 0.65) with JAKi compared to placebo.
- Significantly higher incidence of varicella-zoster infections observed (OR: 1.72).
- Increased risk of herpes simplex infections noted in patients with atopic dermatitis to alopecia areata (OR: 1.73).
Conclusions:
- Systemic JAKi for dermatologic indications do not appear to increase the risk of serious or opportunistic infections.
- Vigilance is warranted for varicella-zoster and herpes simplex infections, particularly in specific patient populations like those with atopic dermatitis.
- Short-term safety is supported, but long-term monitoring for herpes virus infections is recommended.
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