Pill options for eczema: Detailing advantages, disadvantages, and potential complications
In a significant development for people suffering from eczema, the Food and Drug Administration (FDA) has approved two new treatments: abrocitinib (Cibinqo) for adults and upadacitinib (Rinvoq) for individuals aged 12 years and older. These treatments belong to a class of drugs known as Janus kinase (JAK) inhibitors, which aim to control systemic inflammation.
Oral medications, including corticosteroids, immunosuppressants, biologics, and JAK inhibitors, are often used as second-line treatments for eczema. While they offer benefits in reducing itching, redness, and rashes, controlling inflammation, treating severe outbreaks, and preventing flare-ups, they also come with potential side effects.
For instance, oral corticosteroids, while effective, are generally avoided long-term due to side effects such as thinning of the skin, increased susceptibility to infections, weight gain, high blood pressure, mood changes, osteoporosis, and adrenal suppression.
Immunosuppressants, another medication that suppresses the immune system and reduces inflammation, may increase the risk of infections, liver toxicity, kidney effects, and malignancies. The specific side effects vary by drug class and are less detailed in the provided sources.
Biologics, derived from living cells and biological processes, target specific proteins in the immune system to reduce inflammation. Examples include dupilumab and adalimumab. Common side effects of biologics include injection site reactions, conjunctivitis, headache, cough, fever, muscle aches, tiredness, and skin reactions. Serious side effects require urgent medical attention.
JAK inhibitors block cytokines from attaching to certain chemical receptors, helping inhibit inflammation and reducing eczema flare-ups. However, they are associated with increased risks of infections, non-melanoma skin cancers, elevated lipid levels, thrombosis, major cardiovascular events, and malignancies.
In summary, the side effect profiles are distinct but overlap in risks of infections and skin reactions.
| Medication Class | Common Side Effects | Serious Risks | |-----------------------|-----------------------------------------------------------------|----------------------------------| | Oral corticosteroids | Skin thinning, weight gain, mood changes, hypertension | Adrenal suppression, osteoporosis| | Immunosuppressants | Increased infection risk, possible liver/kidney toxicity | Malignancies, organ damage | | Biologics (Dupilumab) | Injection site reactions, conjunctivitis, headache, cough | Severe allergic reactions, eye inflammation | | JAK inhibitors | Skin irritation, infections, increased lipids | Thrombosis, cardiovascular events, malignancies |
These side effects generally reflect what clinicians monitor when using these treatments in eczema patients.
In addition to these medications, the FDA has also approved two biologics for eczema treatment: dupilumab (Dupixent) and tralokinumab-Idrm (Adbry). These treatments can offer benefits such as reduced itching, clear or almost clear skin, improved sleep, and improved quality of life.
It's important to note that for most people, eczema presents itself in early childhood. Around 1 in 10 people will develop eczema in their lifetime, and in the United States, approximately 31.6 million people have eczema.
Emollients, moisturizing treatments that create a protective film over the skin, helping lock in moisture, are available in various forms, including ointments, creams, lotions, and soap substitutes. The American Academy of Dermatology Association (AAD) recommends using mild soaps and detergents, applying a moisturizer at least twice a day, using a humidifier in dry environments, wearing natural, soft fabrics, learning and avoiding individual eczema triggers, and more as home remedies to help alleviate eczema symptoms.
Topical products are the first-line treatment for eczema. Clinical trials demonstrate that JAK inhibitors are safe and effective as a treatment for atopic dermatitis, but further large-scale studies are necessary to understand their long-term safety and treatment success.
In conclusion, while eczema medications come with potential side effects, they also offer hope for those suffering from this condition. It's crucial to discuss treatment options with a healthcare provider to find the best course of action.
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