Experts discuss the mechanism of action of oral Janus kinase (JAK) inhibitors, the impact of selectivity on efficacy and safety, the long-term safety and efficacy of JAK inhibitors in atopic dermatitis (AD) treatment compared with other disease states, and the latest data for the 2 oral JAK inhibitors approved for AD and their implications for treatment.
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.
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 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 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 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 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 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 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 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 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 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.
