Contraindications for Use of JAK Inhibitors in AD

Opinion
Video

Peter Lio, MD, reviews the contraindications of JAK inhibitors in AD and approaches for monitoring patients who are prescribed a JAK inhibitor.

This is a video synopsis/summary of a panel discussion involving Christopher Bunick, MD, PhD; Peter Lio, MD; Lisa Swanson, MD, PhD; and Alexandra Golant, MD.

Dr Lio discusses contraindications and patient monitoring considerations for the use of Janus kinase (JAK) inhibitors in atopic dermatitis. He highlights specific contraindications, including active infections such as tuberculosis, hepatitis B, hepatitis C, and HIV (human immunodeficiency virus). Localized infections, like active shingles, are also reasons to postpone JAK inhibitor initiation. Patients with an active malignancy or a history of cardiac disease or clotting issues require careful consideration due to the potential immunosuppressive effects of JAK inhibitors.

Dr Lio emphasizes that patient selection is crucial, focusing on individuals with severe atopic dermatitis that significantly impacts their quality of life. He mentions that smoking and certain lab abnormalities, like low absolute neutrophil count (ANC) or anemia, are not absolute contraindications but warrant caution. During pregnancy, it is advisable to avoid JAK inhibitors until more safety data is available.

Dr Swanson adds to the discussion, stressing the importance of history-taking in patient assessments. She mentions a case in abrocitinib safety data where a patient with a family history of pulmonary embolism experienced a non-fatal venous thromboembolism (VTE). This highlights the need for physicians to gather comprehensive family history information, demonstrating the importance of the art of medicine in patient care. Additionally, Dr Swanson includes liver and kidney issues in the considerations, suggesting that dose adjustments or avoidance may be necessary based on baseline labs or patient knowledge.

Video synopsis is AI-generated and reviewed by HCPLive editorial staff.

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