Christopher G. Bunick, MD, PhD

This interview segment with Bunick at EADV highlights some of the significance of these recent findings on cardiovascular risk and upadacitinib use over 6 years.

In this EADV interview, Bunick touches on his team’s findings related to risk of VTE, MACE, and malignancy in patients with atopic dermatitis treated with upadacitinib for 6 years.

Panelists discuss how to effectively onboard patients to Janus kinase (JAK) inhibitors through transparent risk discussions, early follow-up visits at 4 weeks, and personalized treatment approaches that consider patient-reported outcomes and the “3 Cs” (cancer, cardiac disease, clotting disease) while emphasizing the anti-inflammatory benefits and quality-of-life improvements these therapies provide.

Panelists discuss how Janus kinase (JAK) inhibitors demonstrate a favorable safety profile across age groups and comorbid populations, with potential cardioprotective benefits due to their anti-inflammatory effects, while addressing common concerns about the boxed warning by emphasizing that only herpes zoster reactivation, tuberculosis, and nonmelanoma skin cancer show increased rates across all indications.

Panelists discuss how abrocitinib demonstrated superior efficacy compared with dupilumab in head-to-head trials, with 77% of dupilumab nonresponders achieving Eczema Area and Severity Index 75 (EASI-75) after switching to abrocitinib for 12 weeks, supported by real-world registry data showing consistent outcomes across diverse patient populations.

Panelists discuss how the Level Up study demonstrated that patients who didn’t achieve Eczema Area and Severity Index 75 (EASI-75) on dupilumab could be successfully switched to upadacitinib without washout, with two-thirds achieving EASI-75 and one-third achieving EASI-90 within just 4 weeks of switching.

Panelists discuss how switching from biologics to Janus kinase (JAK) inhibitors should be considered when patients don’t achieve adequate disease control within 3 to 6 months, experience tolerability issues, or continue to have significant quality-of-life impacts despite apparent skin improvement.

Panelists discuss how oral Janus kinase (JAK) inhibitors offer advantages over biologics in specific clinical scenarios including patients needing rapid onset of action, those with comorbid arthralgia, head and neck involvement, needle fatigue, and environmental trigger sensitivity due to their broad anti-inflammatory effects.

Panelists discuss how the AHEAD recommendations establish evidence-based treatment targets requiring simultaneous achievement of skin clearance (Eczema Area and Severity Index [EASI]-90) and itch relief (itch score 0-1) within 3 to 6 months, fundamentally changing the standard of care by incorporating patient-reported outcomes alongside physician assessments.

Panelists discuss how Janus kinase (JAK) inhibitors represent a revolutionary advancement in atopic dermatitis treatment by targeting multiple cytokine pathways simultaneously at the intracellular level, offering broader therapeutic coverage than biologics that target only 1 or 2 specific cytokines.

This Q&A interview at RAD 2025 features a discussion about a talk titled ‘Assessing the Evidence for OX40-OX40L Axis Inhibition for the Treatment of Atopic Dermatitis.’

In this interview, Christopher Bunick, MD, PhD, speaks on the elements of the RAD 2025 conference that he is most anticipating.

Experts discuss key takeaways for dermatologists managing atopic dermatitis with JAK inhibitors, emphasizing the importance of individualized treatment plans, monitoring for safety and efficacy, and balancing the benefits of JAK inhibitors with potential risks, especially in long-term use.

Experts discuss how clinical judgment guides the decision to increase the dose of a JAK inhibitor, considering factors like patient response and symptom severity, and how often dose escalation is implemented in practice based on individual patient needs.

Experts discuss how data from studies like JADE EXTEND, Heads Up Extension, and LEVEL UP, showing improved outcomes with JAK inhibitors in patients who failed biologic therapy, influence their clinical practice and decision-making when considering switching systemic therapies for patients with atopic dermatitis.

Experts discuss situations where an oral JAK inhibitor might be prescribed initially over a biologic for moderate to severe atopic dermatitis (AD), noting advantages such as oral administration, quicker onset of action, and convenience, which may make it a preferred option for some patients.

Experts discuss the current place of JAK inhibitors in atopic dermatitis management, highlighting their role as an effective oral treatment option within the broader spectrum of therapies, including topical treatments and biologics, depending on disease severity and patient needs.

Experts discuss the necessary monitoring for patients prescribed JAK inhibitors, emphasizing regular assessments for safety and effectiveness, with adjustments in the monitoring plan based on factors such as smoking status and age.

Experts discuss how to effectively communicate the safety of JAK inhibitors to patients with atopic dermatitis, including how to address the FDA boxed warning by emphasizing the balance of risks and benefits and tailoring the conversation based on individual patient concerns and risk factors.

Experts discuss the FDA boxed warning for JAK inhibitors, which highlights risks such as venous thromboembolism (VTE), major adverse cardiac events (MACE), and malignancy originating from the ORAL surveillance trial. They compare these risks in the atopic dermatitis (AD) patient population with those seen in rheumatoid arthritis, noting generally lower incidences in patients with AD.

Experts discuss the long-term efficacy and safety of abrocitinib and upadacitinib in atopic dermatitis (AD), with sustained monotherapy results showing significant improvements in Investigator Global Assessment (IGA), Eczema Area and Severity Index (EASI), and Validated IGA-AD (vIGA-AD) scores. They also consider the safety profiles and potential risks, particularly in older patients, for long-term use of JAK inhibitors.

Experts discuss the significance of using selective JAK1 inhibitors for atopic dermatitis (AD), noting their targeted action compared with nonselective JAK inhibitors, and how JAK1 selectivity enhances both the efficacy and safety of these agents in treating AD.

Experts discuss the JAK/STAT signaling pathway’s critical role in immune response, highlighting the involvement of JAK enzymes in atopic dermatitis (AD) pathogenesis and how JAK inhibitors effectively reduce itch and inflammation, improving symptoms and skin clearance in AD.

A group of 9 experts reflect on what they are looking forward to most in 2025 following the AAD annual meeting.

In this interview with Christopher Bunick, MD, PhD, at AAD 2025, he discusses his update given in a presentation regarding acne and rosacea treatments.

This interview features a discussion with Christopher Bunick, MD, PhD, regarding recent controversies in acne and rosacea related to benzene and benzoyl peroxide.

Looking to the future of atopic dermatitis treatment, the panel discusses ongoing research and promising emerging therapies.

Focusing on clinical scenarios, experts on atopic dermatitis discuss how their treatment approaches vary depending on patient-specific factors.

Dermatologists outline the role of targeted therapies and JAK inhibitors in the treatment of patients with atopic dermatitis.

Following a review of findings from the LEVEL UP study, an expert on atopic dermatitis shares what we’ve learned from long-term data on upadacitinib and JAKi.