IL-12/23, IL-23 Antagonists Increase Risk of Upper Respiratory Tract Infections

IL-12/23 or IL-23 antagonists significantly increase the risk of upper respiratory tract infections in patients with autoimmune diseases, according to results from a meta-analysis.

Noting that respiratory tract infections and interstitial lung disease have been reported in patients with autoimmune disease treated with IL-12/23 and IL-23 antagonists, the researchers conducted a systematic review and meta-analysis to assess this risk. Their investigation included 54 randomized controlled trials spanning 10,907 patients treated with 6 IL-12/23 or IL-23 antagonists and 5175 patients who received placebo.
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The researchers compared the risk of respiratory tract infections, as well as noninfectious interstitial lung disease, with IL-12/23 or IL-23 antagonists vs placebo.

Treatment with IL-12/23 or IL-23 antagonists significantly increased the risk of respiratory tract infections, particularly upper respiratory tract infections, the researchers reported. However, the therapies did not increase the risk of viral upper respiratory tract infections or lower respiratory tract infections, including infectious pneumonia.

Furthermore, the risk of noninfectious interstitial lung disease, including eosinophilic pneumonia and pneumonitis, did not differ between patients treated with IL-12/23 or IL-23 antagonists and placebo, the analysis found.

“This meta-analysis showed that IL-12/23 or IL-23 antagonists had an increased risk of upper respiratory tract infections, but not viral upper respiratory tract infections, lower respiratory tract infections including infectious pneumonia, and noninfectious interstitial lung disease,” the researchers concluded.

—Jolynn Tumolo

Reference

Akiyama S, Yamada A, Micic D, Sakuraba A. The risk of respiratory tract infections and interstitial lung disease with IL-12/23 and IL-23 antagonists in patients with autoimmune diseases: a systematic review and meta-analysis. J Am Acad Dermatol. Published online August 10, 2020. doi:10.1016/j.jaad.2020.08.026