Age-Stratified Analysis of Adverse Events Associated with oral Jak inhibitor Use: A Multicenter Cohort Study

Presenter: Saakshi Khattri

Oral Janus kinase inhibitors (JAKi) are used across inflammatory and autoimmune diseases, butbut are associated with a spectrum of adverse events (AEs) . A retrospective cohort study was conducted using the TriNetX Global Collaborative Network to evaluate the incidence of known JAK inhibitor-associated adverse events (AEs) among adult patients with atopic dermatitis, alopecia areata, psoriatic arthritis, Crohn’s disease, ulcerative colitis, ankylosing spondylitis, and rheumatoid arthritis. Patients were stratified by age into three groups (18–39, 40–64, and ≥65 years), with further subgroup analyses performed among older adults (65–74, 75–84, and ≥85 years). Propensity score matching was performed to account for demographic differences, sources of immunosuppression, and JAK inhibitor indications. Cox hazard ratios were calculated for multiple AEs at 1-, 3-, and 5-year follow-up time points. At 5 years, the risk of major adverse cardiovascular events (MACE) was found to increase progressively with age, while venous thromboembolism (VTE) risk was higher among older adults than younger and middle-aged adults. Skin malignancy risk was lower in middle-aged than in older adults. Age-related variations were also observed in infectious adverse events (AEs), with skin and soft-tissue infections occurring more frequently in older adults and herpetic eruptions less frequently in younger adults; upper respiratory infections showed no association with age. Acne and gastrointestinal upset were more frequently reported among younger adults, whereas hyperlipidaemia and elevated liver function tests were less frequent in younger than in older adults.The findings reinforce advanced age as a risk factor for serious JAK inhibitor-associated AEs, whereas younger patients were more likely to experience milder inflammatory and mucocutaneous adverse effects. Nevertheless, the assessment of JAK inhibitor safety profiles across age groups and AE types underscores the importance of age-specific and outcome-specific counselling in clinical practice.

Association Between Tnf-Α, Il-1β, Il-17a, and Il-6 Cytokine Levels and Depression in Patients with Alopecia Areata

Presenter: Canan Dere

Alopecia areata (AA) may involve systemic inflammatory processes and psychosocial comorbidities beyond hair loss. This prospective, cross-sectional, case-control study compared serum cytokine levels and psychological outcomes between 44 patients with AA and 44 age- and sex-matched healthy controls. Disease severity among patients was assessed using the Severity of Alopecia Tool (SALT) score. Serum levels of TNF-α, IL-1β, IL-17A, and IL-6 were measured using enzyme-linked immunosorbent assay (ELISA). All participants completed the Hospital Anxiety and Depression Scale (HADS) and Social Appearance Anxiety Scale (SAAS), while the Dermatology Life Quality Index (DLQI) was additionally administered to patients with alopecia areata. Statistical analyses included between-group comparisons, Spearman’s correlation, and linear regression. Serum interleukin (IL)-6 levels were significantly higher in patients than controls (p=0.013), whereas tumour necrosis factor-alpha (TNF-α) and IL-17A levels did not differ significantly (p>0.05). Patients also had higher Hospital Anxiety and Depression Scale (HADS) depression scores (median: 7 vs. 3), anxiety scores (6 vs. 4), and Social Appearance Anxiety Scale (SAAS) scores (36.5 vs. 19; all p<0.001). The median DLQI score was 3 (IQR: 1–6), suggesting generally mild impairment in quality of life; however, marked impairment was reported in approximately 11% of patients (n = 5). Within the AA group, TNF-α levels showed a weak positive correlation with depression scores (r=0.300; p=0.048). After adjustment for age, sex, and active smoking, log-transformed IL-6 levels were independently associated with depression scores (B=3.598; β=0.352; 95% confidence interval: 0.598–6.599; p=0.024). These findings suggest a possible association between systemic inflammation and depressive symptoms in AA, warranting further investigation in larger prospective studies.

Beyond The Skin: Interferometric Evaluation of Meibomian Gland Dysfunction in Rosacea

Presenter: Asha Asha

Ocular involvement in rosacea may remain undetected despite underlying abnormalities of the ocular surface and meibomian glands. This cross-sectional observational study assessed ocular changes using ocular surface interferometry in 50 patients with clinically diagnosed rosacea. Although ocular symptoms were reported in only 30.3% of patients, meibomian gland loss was observed in 94.1%, matrix metalloproteinase-9 (MMP-9) positivity in 76.5%, and reduced lipid layer thickness in 52.9%. Ocular symptoms were significantly associated with Ocular Surface Disease Index scores (p=0.0129), meibomian gland loss (p=0.0389), and lid margin telangiectasia (p=0.0024). MMP-9 positivity correlated significantly with meibomian gland loss (p=0.0405) and Ocular Surface Disease Index scores (p=0.0124). Meibomian gland loss also showed a strong positive correlation with lid margin telangiectasia (rho=0.728; p=0.0009). Greater rosacea severity showed a trend toward increased ocular involvement. These findings indicate substantial subclinical ocular surface and meibomian abnormalities in rosacea many of which are detectable despite minimal symptoms. Objective interferometric changes may precede overt ocular manifestations, supporting consideration of objective ocular surface assessment even in patients with few symptoms.

Differences in Gut Microbiota and Metabolism Between Rapid and Slow Responders to Omalizumab for Chronic Spontaneous Urticaria

Presenter: Xiaohu Pang

Differences in treatment response to omalizumab in chronic spontaneous urticaria (CSU) may be associated with variations in gut microbiota and metabolic profiles. This study compared baseline fecal microbiota and serum metabolites in 28 patients with CSU classified as rapid or slow responders according to Urticaria Activity Score over 7 days (UAS7) at Week 4. Fecal samples underwent 16S ribosomal ribonucleic acid (rRNA) gene sequencing, while serum samples were analysed using untargeted metabolomics. Among 2,070 valid sequences, Clostridia, Oscillospirales, and Ruminococcaceae were more abundant in slow responders, whereas Rikenellaceae, Leuconostocaceae, and Weissella cibaria were enriched in rapid responders (all P<0.05). Functional prediction identified differences in pathways including sphingolipid metabolism and AMP-activated protein kinase (AMPK) signalling. Of 2,676 metabolites identified, 197 differed between groups: 29 were upregulated and 168 downregulated, with significant enrichment in fatty acid metabolism pathways (P<0.05). These findings indicate significant differences in gut microbiota composition and metabolic profiles between rapid and slow responders to omalizumab. The results suggest that gut microbiota may contribute to differential treatment responses through metabolism-related mechanisms, particularly fatty acid metabolism.

Ixekizumab with Tirzepatide Was Associated with Reduced CV Risk Factors and Calculated CV Risk Beyond Ixekizumab Alone in Psoriatic Disease and Obesity

Presenter: Brittany Weber

Psoriasis (PsO) and psoriatic arthritis (PsA) are associated with elevated cardiovascular (CV) risk, which may be further increased by overweight or obesity. Two Phase 3b trials, TOGETHER-PsO and TOGETHER-PsA, compared ixekizumab (IXE) plus tirzepatide (TZP) with IXE alone in patients with moderate-to-severe PsO or active PsA and overweight or obesity. Participants were randomised 1:1 and received individualised diet and exercise counselling. At Week 36, IXE+TZP was associated with greater improvements than IXE alone across multiple cardiometabolic parameters in both PsO and PsA, including weight, systolic and diastolic blood pressure, triglycerides, glucose, glycated haemoglobin (HbA1c), high-sensitivity C-reactive protein (hsCRP), and waist-to-height ratio. Using Framingham equations, post-hoc analyses demonstrated that calculated 10-year cardiovascular disease risk was approximately 30% lower with IXE+TZP than with IXE alone, corresponding to predicted hazard ratios of 0.70 (95% confidence interval 0.63-0.78) in PsO and 0.69 (95% CI: 0.62-0.78) in PsA. These findings suggest that combining anti-inflammatory and metabolic treatment may improve cardiometabolic profiles and reduce predicted cardiovascular risk in this population.

Predicting Response to Omalizumab in Chronic Spontaneous Urticaria: Initial Findings from The Global Multicenter Ucare Scopus Project

Presenter: Dimitra Gialama

Predicting treatment response to omalizumab in chronic spontaneous urticaria (CSU) remains challenging, as available biomarkers have not yet been integrated into a clinically useful grading system. The ambispective, global multicentre UCARE SCOPUS study assessed baseline clinical and laboratory biomarkers associated with disease control during omalizumab treatment. Among 1,737 adults from 39 Urticaria Centers of Reference and Excellence across 24 countries, 71.1% were female, mean age was 45.0 years, and mean disease duration was 5.7 years. Baseline biomarkers evaluated included eosinophil and basophil counts, C-reactive protein, total immunoglobulin E (IgE), IgG anti-thyroid peroxidase antibodies, autologous serum skin test (ASST), and basophil assays. At Month 3, poorly controlled patients had higher baseline frequencies of eosinopenia (16.6% vs. 11.7%; p=0.043), low total immunoglobulin E (IgE; 37.6% vs. 16.6%; p<0.001), elevated IgG anti-thyroid peroxidase antibodies (23.9% vs. 16.7%; p=0.018), and positive autologous serum skin tests (56.3% vs. 42.3%; p=0.020) than well-controlled patients. A trend toward higher rates of positive basophil activation testing was also observed among poorly controlled patients. Conversely, higher baseline total IgE was associated with better disease control. Among all biomarkers evaluated, baseline Total IgE and autologous serum skin test results showed consistent associations with omalizumab response at Months 3,6 and 12. These findings indicate that CSU patients with well-controlled and poorly controlled disease exhibit distinct baseline biomarker profiles and support further development of a clinically applicable scoring system to predict omalizumab treatment response. 

EADV Congress 2026, 30 SEP - 03 OCT 26, Vienna