Cardiometabolic Associations of Dermatological Treatments. Part II: Targeted and Biologic Therapies

Targeted and biologic therapies are increasingly being used for treatment of dermatological conditions. Certain agents are associated with cardiometabolic toxicities, including major adverse cardiovascular events and altered lipid profiles, necessitating baseline and on-treatment monitoring. Close cardiometabolic monitoring is needed throughout treatment with co-management by cardiology, endocrinology, rheumatology, oncology, and primary care for symptomatic or high-risk patients. Conversely, some therapies may reduce systemic inflammation and atherogenic factors, possibly conferring reduced risk of cardiometabolic events. Randomized, controlled trials in dermatological populations are needed to corroborate these observations. In part II of this two-part continuing medical education series, we describe cardiometabolic effects of targeted and biologic therapies, including immune checkpoint inhibitors, antitumor monoclonal antibodies, intravenous immunoglobulins, Janus kinase inhibitors, tumor necrosis factor inhibitors, interleukin inhibitors, and apremilast. In addition, we outline recent advances in pathophysiology and supplement with practical recommendations for baseline assessment and monitoring in dermatological patients.