Practical Considerations When Selecting Systemic Therapies


Expert advanced practice providers in dermatology share practical considerations on implementing novel systemic therapies into clinical practice.

This is a video synopsis/summary of a panel discussion involving Melodie Young, NP, and Andrea Nguyen, PA.

In this conversation, the focus is on the considerations and patient types for using systemic Jack inhibitors and topical JAK (Janus kinase) therapy for dermatological conditions. The clinicians discuss the challenges and warnings associated with these agents, drawing parallels with past experiences with topical calcium urine inhibitors.

Melodie Young, NP, initiates the conversation by asking Andrea Nguyen, PA, about specific patient profiles that should be avoided when using systemic JAK inhibitors or topical JAK therapy. The clinicians delve into the decision-making process, emphasizing the need to consider comorbidities, pregnancy, and other factors.

Andrea Nguyen, PA, highlights the importance of patient commitment, discussing the distinction between injectables and oral agents. She mentions the potential waning of efficacy with oral agents due to stop-and-start patterns. The conversation touches on the safety considerations for systemic JAK inhibitors, particularly in patients with a history of blood clots, clotting disorders, or concurrent malignancies.

Nguyen further discusses the limited systemic absorption of topical JAK inhibitors and how it differs from oral agents in terms of safety considerations. She provides insights into specific patient types where caution is warranted, including those with cardiac risk factors, immunosuppressive agents, or complex drug interactions.

The clinicians touch on the relevance of age in choosing therapy, noting that younger patients may be more straightforward candidates for oral JAK inhibitors. They also briefly mention the flexibility of dosing with a biologic, such as tralokinumab, allowing patients to reduce dosing frequency once achieving clearance.

Overall, the conversation provides valuable insights into the considerations clinicians weigh when deciding on systemic or topical JAK inhibitors for dermatological conditions, emphasizing the importance of tailoring treatment to individual patient characteristics and medical history.

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

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