Neal Bhatia, MD: The Current Landscape of TYK, JAK Inhibitors

In another interview segment with HCPLive, Neal Bhatia, MD, discussed some of the major takeaways from his presentation at the Clinical Dermatology 2023 Conference for PAs & NPs, including views on the present and future of TYK and JAK inhibitor research.

Bhatia works as a dermatologist in Southern California and as Director of Clinical Dermatology at Therapeutics Clinical Research, as well as chief medical editor for Practical Dermatology.

He first went into a response to those in the dermatology who have had concerns over black box warnings on JAK inhibitors.

“I'm the first to call out dermatologists as being afraid of their own shadow, which is unfortunate,” Bhatia stated. “You know, there's this whole mantra of ‘I'm not comfortable, I don't want to write for these drugs, I don't want to get labs’...I think it's a terrible shame, because it's going to force us to not only lose our scope of practice to the allergists and the rheumatologists, but even more so, it just makes us look like we don't know what we're doing.”

Bhatia added that if clinicians feel comfortable enough writing methotrexate prescriptions that they should be comfortable enough writing JAK inhibitors because, he states, they are much safer drugs and there is no reason not to write them even more.

“You know, the pharmaceutical industry is handcuffed by what they can say, especially our sales reps,” he noted. “You know, a lot of dermatologists don't even see sales reps and even when they do, it's for 5 seconds and they get a minimal message that's off the script. And what we have to pay attention to is again, apply the mechanism of action of the therapy that matches the building blocks of a disease that's made. That's how we can achieve good outcomes.”

When asked about the current landscape of therapies, Bhatia commented that dermatologists should be better advocates for using serious drugs.

“I just think we're at risk of losing our scope if we don't get our foot off the brake and put it back on the gas,” he said. “There are so many diseases that need drugs. But they're never going to get a phase 3 indication trial for it because they're small, or they're more esoteric, or they're very similar to conditions we treat.”

Bhatia continued along this line of discussion, noting that some strides have been made but more need to be explored.

“Obviously, ruxolitinib is a topical Janus kinase inhibitor that's for atopic dermatitis and vitiligo, so that's helpful,” he stated. “But again, I think you look at why we would use steroids? Why would we use immunosuppressants? And could Janus kinase inhibitors as a class take over that field? And I think there's a good rationale that says yeah.”

To learn more about Bhatia's views and conference talk, watch the full interview segment above.

The quotes contained in this description are edited for clarity.