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Dermatology

Systemic Immunomodulators

Built from Dermatology, 5th Edition

The first 25 slides of Systemic Immunomodulators
The first 25 slides, exactly as they appear. The full deck has 166 content slides.

What’s inside

13 sections · 166 slides

  1. 01

    Overview

    • What this chapter covers

    1 slide

  2. 02

    Interferons

    Proteins the body makes to fight viruses, borrowed as injectable therapy

    • What interferons are
    • Injection-site skin damage
    • How interferons work inside cells
    • Mechanisms of action for interferons.
    • Approved dermatologic uses
    • Interferons.
    • Dermatologic uses, side effects, and interactions of interferons.
    • Dermatologic uses, side effects, and interactions of interferons. (continued)
    • Dermatologic uses, side effects, and interactions of interferons. (continued)
    • Dermatologic uses, side effects, and interactions of interferons. (continued)
    • A drug side effect that mimics disease
    • Colony-stimulating factors: GM-CSF and G-CSF
    • Granulocyte–macrophage and granulocyte colony stimulating factors (GM-CSF &G-CSF).
    • Granulocyte–macrophage and granulocyte colony stimulating factors (GM-CSF &G-CSF). (continued)
    • Granulocyte–macrophage and granulocyte colony stimulating factors (GM-CSF &G-CSF). (continued)
    • Granulocyte–macrophage and granulocyte colony stimulating factors (GM-CSF &G-CSF). (continued)
    • Injection-site reaction to GM-CSF

    17 slides

  3. 03

    Targeted Immune Modulators

    Drugs engineered to block one specific protein driving skin disease

    • What targeted immune modulators are
    • How antibody drug names are built
    • Nomenclature for monoclonal antibodies and fusion proteins.
    • Sites of action of targeted immune modulators
    • Screening before starting therapy
    • Recommended evaluation for patients receiving targeted immune modulators for dermatologic disorders.
    • Recommended laboratory testing before and during treatment
    • Why hepatitis screening matters
    • Hepatitis B and C serologic test interpretation
    • US Food and Drug Administration (FDA) warnings and precautions for targeted immune modulators with dermatologic indications.
    • US Food and Drug Administration (FDA) warnings and precautions for targeted immune modulators with dermatologic indications. (continued)
    • US Food and Drug Administration (FDA) warnings and precautions for targeted immune modulators with dermatologic indications. (continued)
    • US Food and Drug Administration (FDA) warnings and precautions for targeted immune modulators with dermatologic indications. (continued)
    • US Food and Drug Administration (FDA) warnings and precautions for targeted immune modulators with dermatologic indications. (continued)

    14 slides

  4. 04

    TNF Inhibitors

    Etanercept, infliximab, adalimumab, golimumab, certolizumab pegol

    • What TNF is and why it is targeted
    • Mechanism of action of the TNF inhibitors
    • How the five TNF inhibitors differ
    • Who should not receive TNF inhibitors
    • FDA warnings across all targeted immune modulators
    • Infection risk with TNF inhibitors
    • Cancer risk with TNF inhibitors
    • Autoimmunity, nerve, and heart effects
    • Etanercept clearing a lupus skin rash
    • Skin reactions caused by TNF inhibitors
    • Psoriasiform reactions to TNF inhibitors
    • Cutaneous side effects of targeted immune modulators.
    • Cutaneous side effects of targeted immune modulators. (continued)
    • Cutaneous side effects of targeted immune modulators. (continued)
    • Vaccination and TNF inhibitors
    • Vaccines that contain live attenuated viruses or bacteria.
    • TNF inhibitors in pregnancy
    • Etanercept
    • Etanercept injection-site reaction
    • Infliximab
    • Adalimumab
    • Golimumab and certolizumab pegol
    • Biosimilars of TNF inhibitors
    • Examples of biosimilars of monoclonal antibodies used in dermatology
    • Examples of biosimilars of monoclonal antibodies used in dermatology (continued)
    • Examples of biosimilars of monoclonal antibodies used in dermatology (continued)

    26 slides

  5. 05

    Interleukin-12/23 and Interleukin-23 Inhibitors

    Ustekinumab, guselkumab, risankizumab, tildrakizumab

    • IL-12 and IL-23: two related cytokines
    • Sites of action of IL-12/23 and IL-23 inhibitors
    • Safety of IL-12/23 and IL-23 inhibitors
    • Ustekinumab
    • Guselkumab, tildrakizumab, and risankizumab

    5 slides

  6. 06

    Interleukin-17 Inhibitors

    Secukinumab, ixekizumab, brodalumab - plus spesolimab for IL-36

    • Why block interleukin-17
    • Sites of action of IL-17 inhibitors
    • Safety shared across IL-17 inhibitors
    • Ixekizumab and secukinumab
    • Brodalumab: efficacy and a safety warning
    • Spesolimab: a different target, IL-36

    6 slides

  7. 07

    Interleukin-4/13 Receptor and Interleukin-13 Inhibitors

    Dupilumab, tralokinumab, and lebrikizumab for atopic dermatitis

    • IL-4 and IL-13: the atopic dermatitis cytokines
    • Sites of action of IL-4/13 receptor and IL-13 inhibitors
    • Shared side effect: the eye problem
    • A severe example: ectropion
    • Conjunctivitis and ectropion on dupilumab therapy
    • Dupilumab
    • Tralokinumab

    7 slides

  8. 08

    Interleukin-1 Inhibitors

    Anakinra, canakinumab, and rilonacept for autoinflammatory disease

    • IL-1 and the inflammasome
    • Shared safety of IL-1 blockers
    • Anakinra
    • Canakinumab and rilonacept

    4 slides

  9. 09

    Rituximab

    An antibody that removes CD20-positive B cells

    • Rituximab: removing the B cells
    • What rituximab treats
    • Rituximab risks

    3 slides

  10. 10

    Omalizumab

    An anti-IgE antibody for chronic hives

    • Omalizumab: blocking IgE
    • Omalizumab dosing and safety

    2 slides

  11. 11

    Janus Kinase (JAK) Inhibitors

    Oral pills that block cytokine signaling one step inside the cell

    • Janus kinases: one step inside the cell
    • Mechanism of action of Janus kinase (JAK) inhibitors
    • The seven approved JAK inhibitors
    • Who should avoid JAK inhibitors
    • JAK inhibitor side effects
    • Abrocitinib and baricitinib
    • Deucravacitinib and ritlecitinib
    • Ruxolitinib, tofacitinib, and upadacitinib

    8 slides

  12. 12

    Under Investigation and Other Targeted Therapies

    The biologic-drug pipeline reaches far beyond dermatology

    • The pipeline keeps growing
    • Targeted immune modulators for psoriasis under development.
    • Targeted immune modulators for psoriasis under development. (continued)
    • Other biologic agents used across medicine
    • Other targeted (“biologic”) agents used in medicine.
    • Other targeted (“biologic”) agents used in medicine. (continued)
    • Other targeted (“biologic”) agents used in medicine. (continued)
    • Other targeted (“biologic”) agents used in medicine. (continued)
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    48 slides

  13. 13

    Intravenous Immune Globulin (IVIg)

    Pooled donor antibody used for a short list of skin diseases

    • What IVIg is
    • How IVIg calms the immune system
    • What IVIg treats in dermatology
    • Uses of IVIg in dermatology.
    • Uses of IVIg in dermatology. (continued)
    • Uses of IVIg in dermatology. (continued)
    • Choosing an IVIg product
    • Selected preparations of IVIg that are available in the US.
    • IVIg safety and contraindications
    • Putting it together
    • Each drug class, and its lead skin target
    • References
    • References (continued)
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    • Dermatology, 5th Edition (2-Volume Set)

    25 slides