Jonathan I. Silverberg, MD, PhD: Oral JAK Inhibitor Developments

In this interview segment, Jonathan I. Silverberg, MD, PhD, discussed his presentation from the Revolutionizing Atopic Dermatitis (RAD) 2023 Annual Meeting in Washington, DC, on new insights into oral JAK inhibitors for atopic dermatitis (AD).

Silverberg serves as Associate Professor of Dermatology for the Yale School of Medicine and Health Sciences in DC.

“There’s so much going on in this space right now,” he explained. “We have multiple new JAK inhibitors, more that are being studied. But when a drug first comes to market, we often have a fairly limited amount of information.”

He added that for the first 2 oral JAK inhibitors in the US, abrocitinib and upadacitinib, involved huge clinical trial programs.

“But the clinical trial designs that the (US Food and Drug Administration) or the (European Medicines Agency) ask for are usually pretty rudimentary…that standard regulatory framework,” Silverberg stated. “...they work and they meet some FDA definition of efficacy. But now what? And so we've been gaining a lot more insights recently, from multiple post-hoc analyses from additional real world studies being done.”

Silverberg noted that in his presentation, he wished to provide clinicians with an update for what they may actually do with new JAK inhibitor drugs and what is meaningful in the recent studies that have been done.

“We also got to talk about use of the oral JAK inhibitors specifically in the subset of patients who previously failed dupilumab or other systemic therapies and what the data showed for that. We need more data, but the data that we do have so far are quite reassuring that these drugs work very well, even those tougher patients.”

Later, Silverberg described several more takeaways from his presentation on JAK inhibitor drugs, explaining what new data had indicated for several of them.

“We talked about some additional subsetting that may not be actually important, by looking at certain comorbidities,” he said. “Whether or not the presence of asthma or other atopic comorbidities makes a difference in terms of whether or not we should choose dupilumab or abrocitinib or dupilumab versus upadacitinib and, in fact, it doesn't really seem to make much of a difference. Drugs work just as well, with or without the presence of those comorbidities.”

To learn more about other parts of this discussion with Silverberg, view the full interview segment above.