Top 5 Most-Read Inflammation Articles in 2021

This year's most-read inflammation articles included ones about Janus kinase (JAK) inhibitors and the impact of biologics or systemic corticosteroids on severe COVID-19.

5. Some JAK Inhibitors to Carry More Black Box Warnings for Cardiovascular Concerns

In September, the FDA expanded warnings to some JAK inhibitors when used for certain chronic inflammatory conditions. After a review of a large randomized safety clinical trial, the FDA said it “concluded there is an increased risk of serious heart-related events such as heart attack or stroke, cancer, blood clots, and death with the arthritis and ulcerative colitis medicines Xeljanz and Xeljanz XR (tofacitinib).” This trial compared tofacitinib with tumor necrosis factor (TNF) inhibitors in patients with rheumatoid arthritis, and results showed an increased risk of blood clots and death with the lower dose of tofacitinib.

The FDA said it would require 2 other JAK inhibitors, baricitinib (Olumiant) and upadacitinib (Rinvoq), to carry the same warning, due to a similar mechanism of action.

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4. Study: Half of Patients Make "Critical Errors" When Using Inhalers

In a study published in August, most patients said they had received instruction on how to use their inhalers from a pharmacist or physician, but only 21% said they had received instruction from both. More work needs to be done to educate patients on how to most effectively use their devices, according to the cross-sectional study of patients with obstructive lung disease in Belgium.

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3. Daily Life Activity Creates Triggers in Mast Cell Disorders

A story published in October describes the many challenges faced by patients with mast cell disorders, which involve unpredictable, disabling symptoms that interfere with daily life activities. Mast cell disorders involve unpredictable, disabling symptoms that interfere with daily life activities. Mast cell activation may be induced spontaneously or by triggers, releasing mediators such as tryptase, histamine, leukotrienes, and prostaglandins. Multiple organs can be affected and anaphylaxis is possible.

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2. ICER Review of AD Therapies Narrowly Supports JAK Inhibitors, Depending on Safety

Using findings in an earlier report from the Institute for Clinical and Economic Review, the New England Comparative Effectiveness Public Advisory Council (CEPAC) narrowly voted that 3 JAK inhibitors for atopic dermatitis (AD) provide a net health benefit. The New England CEPAC voted 11-2 on tralokinumab, 9-4 on upadicitinib, 8-6 on abrocitinib, and 7-6 on baricitinib that the evidence was adequate to demonstrate the therapies when added to usual care provided a net health benefit in adults with moderate to severe AD.

For adolescents with mild to moderate AD, CEPAC voted 12-1 that the evidence was adequate to demonstrate ruxolitinib cream provided a net health benefit compared with topical emollients alone.

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1. Systemic Corticosteroids, but Not Biologics, Worsen COVID-19 Outcomes in Patients With Asthma

Patients who take biologics or systemic corticosteroids (SCS) to control their asthma are not at a higher risk of SARS-CoV-2 infection, but those taking steroids have a greater likelihood of severe disease if they become infected, according to an Israeli study. Researchers examined records for more than half of the population to identify patients with asthma who used biologics or SCS, and then compared their COVID-19 infection rates and outcomes to those of the general population. The more often a patient used systemic corticosteroids, the higher their risk of moderate or severe COVID-19 and all-cause mortality, the study found.

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