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In a study performed by Robinson et al43 where 70 patients received Ritlecitinib, only 9 patients reported mild treatment-related adverse effects, among them, it was found mild lymphopenia, mild hepatotoxicity, arthralgias, peripheral edema, pruritus and 1 patient reported suicidal ideation that resolved with treatment withdrawal.43 The most common adverse effects continued to be infections and infestations, influenza occurred in 7.1% of patients, and 1 case of herpes simplex was reported.43 No patient developed bleeding events, platelet count reductions of 100 x 103/mm3, or clinically significant symptoms of anemia or hemodynamic compromise.43 Ritlecitinib performed better when evaluated for adverse effects related to cell counts, thrombopoiesis, and erythropoiesis in comparison with previously studied JAK2 inhibitors.43
The pharmacokinetics of ritlecitinib in humans are predicted to be as follows: The drug has a blood clearance of 5.6 mL/min/kg, a steady-state volume of distribution of 1.3 L/kg, a 90% oral bioavailability, and a systemic half-life of 2 hours.42
As previously stated, JAK inhibitors suppress the immune system, and their primary side effect is susceptibility to infections. Upper respiratory tract and nasal infections are the most common ones, which occur in more than 10% of patients.53 Less common infections include tuberculosis,52 herpes simplex, herpes zoster,53 and oral candidiasis.
JAK inhibitors may affect cholesterol levels, (Table 4)58 and the health-care provider may need to prescribe a statin drug. Blood clots can form, increasing the likelihood of cardiovascular events, pulmonary embolism, and deep vein thrombosis.59 Liver damage is also a possible adverse reaction with JAK inhibitor use, and finally, these drugs are contraindicated in patients with diverticulitis, as they can lead to viscous perforation.56,57Table 4 JAK Inhibitors Adverse Effects33 59ce067264
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