IL-12 and IL-23 Inhibitors: Effective Treatment for Autoimmune Diseases

Introduction: Key Points on IL-12 and IL-23 Inhibitors

Interleukin-12 and Interleukin-23 (IL-12 and IL-23) inhibitors are medications used to treat autoimmune conditions such as psoriasis and Crohn’s disease. These drugs work by targeting specific proteins in the immune system that contribute to inflammation. IL-12 and IL-23 inhibitors are often recommended for patients who have not responded well to other treatments. If you have any questions about your treatment options, our telemedicine providers are here to assist you.

Medications within the IL-12 and IL-23 Inhibitor Drug Class

Common IL-12 and IL-23 inhibitors include:

1. Ilumya (tildrakizumab-asmn)
2. Skyrizi (risankizumab-rzaa)
3. Tremfya (guselkumab)

The generic name refers to the chemical composition of the medication, while the brand name is assigned by the manufacturer. The generic name is listed in parentheses.

How Do IL-12 and IL-23 Inhibitors Work? Mechanism of Action Explained

IL-12 and IL-23 inhibitors block the activity of two immune system proteins: interleukin-12 (IL-12) and interleukin-23 (IL-23). These proteins play a key role in promoting inflammation, which leads to symptoms of autoimmune diseases like psoriasis and Crohn’s disease. By inhibiting these proteins, the medications help reduce inflammation and manage symptoms.

While all drugs in this class target IL-23, some also inhibit IL-12. For example, Ilumya, Skyrizi, and Tremfya primarily block IL-23, which is particularly important in autoimmune conditions. This selective inhibition helps reduce inflammation with fewer side effects compared to older treatments that target both IL-12 and IL-23.

Benefits of IL-12 and IL-23 Inhibitors for Autoimmune Diseases

IL-12 and IL-23 inhibitors are used to treat moderate to severe autoimmune conditions, such as plaque psoriasis and Crohn’s disease. These medications are often prescribed when other treatments, like topical creams or oral medications, have not been effective. One of the key advantages of IL-12 and IL-23 inhibitors is their ability to provide long-term symptom relief with fewer side effects compared to older biologic treatments, such as TNF inhibitors.

Additionally, these medications are administered less frequently, offering greater convenience. Some IL-12 and IL-23 inhibitors are given as injections every few months, making them a more manageable option for long-term treatment. If you’re considering this therapy, our telemedicine providers can help you determine if it’s the right choice for you.

Potential Side Effects of IL-12 and IL-23 Inhibitors

Like all medications, IL-12 and IL-23 inhibitors may cause side effects. While many patients tolerate these drugs well, it’s important to be aware of potential side effects and discuss any concerns with your healthcare provider. Below is a list of possible side effects, ordered from most common to least common, along with their approximate occurrence rates where available.

Common Side Effects (Greater than 1%)

1. Upper respiratory infections (13-15%): Symptoms may include a runny nose, sore throat, and cough. Patients with a history of frequent respiratory infections may be at higher risk.
2. Headache (8-12%): Some patients report mild to moderate headaches. Staying hydrated and resting may help alleviate this symptom.
3. Fatigue (5-8%): Feeling unusually tired or fatigued is common. This may improve as your body adjusts to the medication.
4. Injection site reactions (3-5%): Redness, pain, or swelling at the injection site can occur. These reactions are usually mild and resolve on their own.
5. Back pain (2-4%): Some patients experience mild to moderate back discomfort.
6. Diarrhea (1-3%): Diarrhea may occur, especially in the initial weeks of treatment. Staying hydrated and eating a bland diet can help manage this symptom.

Less Common Side Effects (Less than 1%)

These side effects are rare but have been reported. If you experience any of the following, contact your healthcare provider:

1. Severe allergic reactions
2. Increased risk of infections (e.g., tuberculosis, fungal infections)
3. Depression or mood changes
4. Weight gain
5. Joint pain
6. Abdominal pain
7. Rash
8. Swelling of the face, lips, or tongue

Severe Side Effects of IL-12 and IL-23 Inhibitors

While rare, some side effects can be serious and require immediate medical attention. These include:

1. Serious infections: IL-12 and IL-23 inhibitors can weaken your immune system, making it harder to fight infections. If you develop a fever, persistent cough, or other signs of infection, contact your doctor immediately.
2. Allergic reactions: Signs of a severe allergic reaction include difficulty breathing, swelling of the face or throat, and severe rash. Seek emergency medical care if you experience any of these symptoms.
3. New or worsening autoimmune conditions: In rare cases, these medications may trigger or worsen autoimmune diseases. If you notice new symptoms like unexplained joint pain, skin rashes, or muscle weakness, consult your healthcare provider.

It’s crucial to speak with your doctor before starting IL-12 and IL-23 inhibitors, especially if you have a history of infections, tuberculosis, or other immune-related conditions. If you have concerns about side effects, our telemedicine providers are available to help you understand the risks and benefits of this treatment.

Drug to Drug Interactions with IL-12 and IL-23 Inhibitors

IL-12 and IL-23 inhibitors can interact with other medications, potentially affecting their efficacy or increasing the likelihood of side effects. It’s important to inform your healthcare provider about all the medications you are currently taking, including over-the-counter drugs, supplements, and herbal remedies. Below are some common drug interactions to be aware of:

Immunosuppressants: Taking other immunosuppressive medications (such as methotrexate or corticosteroids) alongside IL-12 and IL-23 inhibitors may increase your risk of infections.

Live vaccines: Avoid receiving live vaccines (such as MMR or varicella) while on IL-12 and IL-23 inhibitors. These medications can weaken your immune system, reducing the effectiveness of the vaccine or increasing the risk of infection from the vaccine itself.

Biologic therapies: Combining IL-12 and IL-23 inhibitors with other biologic therapies (such as TNF inhibitors) may elevate the risk of serious side effects, including infections and further suppression of the immune system.

If you’re uncertain whether your current medications may interact with IL-12 and IL-23 inhibitors, our telemedicine providers can review your medication list and offer personalized guidance.

Precautions and Contraindications for IL-12 and IL-23 Inhibitors

Before starting treatment with IL-12 and IL-23 inhibitors, it’s essential to discuss your medical history with your healthcare provider to ensure this therapy is appropriate for you. Certain conditions may increase the risks associated with these biologic drugs:

Infections: If you have an active infection or a history of recurrent infections, IL-12 and IL-23 inhibitors may not be suitable for you. These medications can suppress your immune system, making it more difficult to fight off infections.

Tuberculosis: Patients with a history of tuberculosis (TB) or those who have been exposed to TB should undergo screening before starting IL-12 and IL-23 inhibitors, as these medications can reactivate latent TB.

Hepatitis B or C: If you have a history of hepatitis B or C, it’s important to inform your doctor. IL-12 and IL-23 inhibitors may increase the risk of reactivating these viral infections.

Pregnancy and breastfeeding: The safety of IL-12 and IL-23 inhibitors during pregnancy and breastfeeding has not been fully established. If you are pregnant, planning to become pregnant, or breastfeeding, discuss the potential risks and benefits of IL-12 or IL-23 therapy with your healthcare provider.

Allergic reactions: If you have experienced severe allergic reactions to biologic medications in the past, IL-12 and IL-23 inhibitors may not be the right choice for you.

Regular check-ups and blood tests are crucial while using IL-12 and IL-23 inhibitors to monitor for potential side effects or complications. Our telemedicine providers are available to help you stay on track with your treatment plan and ensure you receive the care you need.

Conclusion: Managing Your Health with IL-12 and IL-23 Inhibitors

IL-12 and IL-23 inhibitors are highly effective treatments for managing chronic inflammatory conditions such as psoriasis and Crohn’s disease. While they can provide significant relief for many patients, it’s important to remain mindful of potential side effects, drug interactions, and necessary precautions. By working closely with your healthcare provider, you can make informed decisions about your treatment and reduce potential risks.

If you have any questions or concerns about IL-12 and IL-23 inhibitors, our telemedicine team is here to support you. Schedule a consultation with one of our providers today to discuss whether this treatment is right for you and to ensure you’re taking the appropriate steps to manage your health effectively.

James Kingsley

Learn More