Brett King, MD, PhD: Safety Concerns in Atopic Dermatitis Patients with JAK Inhibitors

Brett King, MD, PhD, Associate Professor of Dermatology from Yale School of Medicine, spoke about his view on the way clinicians and patients should approach JAK inhibitors with regard to atopic dermatitis (AD).

King’s discussion regarded his presentation at the the Revolutionizing Atopic Dermatitis (RAD) 2023 Annual Meeting in Washington, DC.

“There's a lot of interest in JAK inhibitors and dermatology,” King said. “The first oral JAK inhibitors that were approved over a little over a year ago now were approved in atopic dermatitis, the subject of the meeting, and as much excitement as there is around them, there's also been a lot of attention in the media about the safety profile of JAK inhibitors."

Due to this fact, King noted that he believes it is paramount that clinicians and patients make sure to understand where the box warning comes from in the first place.

“They put it in proper context,” he stated, regarding about black box warnings. “Because without that, we're going to really struggle to use this class of medicines as we should be. Because, truly, JAK inhibitors have a remarkable ability to make patients who are suffering from atopic dermatitis better.”

King continued to discuss some of the most important takeaways regarding safety concerns for these drugs in AD patients.

“What's really important for everybody to understand is that the box warnings for JAK inhibitors in dermatology, the box warning for JAK inhibitors and atopic dermatitis, come from a long term safety study of a JAK inhibitor in patients with rheumatoid arthritis, older patients being treated with methotrexate prednisone, and all with multiple comorbidities.”

Even in that population of the ORAL Surveillance Study, King noted, the risk of malignancy and the risk of major adverse cardiovascular events was found to be quite low. He added that for essentially healthy patients, clinicians should not be afraid to consider JAK inhibitors.

“The oral JAK inhibitors added enormously to the treatment landscape of moderate to severe atopic dermatitis,” he said. “Topical ruxolitinib added enormously to the treatment toolbox of mild-to-moderate atopic dermatitis. And this is only going to get better as we understand better the patients in whom we should be reaching for these medicines.”

For more information from this presentation, view the full interview above.