Brett King, MD, PhD: The Promise of Janus Kinase Inhibitors

Janus kinase (JAK) inhibitors are an emerging class for the field of dermatology.

While these small molecule drugs have seen approvals in other domains—such as tofacitinib (Xeljanz) and upadacitinib (Rinvoq) for rheumatoid arthritis and ulcerative colitis—they have yet to make full headway into the dermatology space.

As of now, no drug has been approved for any single dermatologic condition. Currently, the US Food and Drug Administration (FDA) are reviewing applications for a variety JAK inhibitors—namely baricitinib, abrocitinib, upadacitinib, and ruxolitinib cream for the treatment of atopic dermatitis—but the agency has recently announced delays on action for all agents.

While safety concerns should not be overlooked or taken lightly, the drug class has demonstrated promising efficacy in patients suffering from dermatologic conditions, including atopic dermatitis, psoriasis, alopecia areata, and vitiligo.

Even more, the safety profile of JAK inhibitors must be understood in the context of previous dermatology- and non-dermatology-related clinical trials—a fact that Brett King, MD, PhD, Associate Professor of Dermatology at Yale School of Medicine, stressed in this episode of Derm Discussions with Brad Glick, DO.

King explained how JAK inhibitors work, emphasizing their potential place inside a dermatologist’s treatment arsenal.

He compared JAKs with biologic agents, like dupilumab, and speculated on the implications the addition of a drug class would have on diagnostic and prescribing strategies, particularly for atopic dermatitis. 

Both Glick and King expressed forward-looking, optimistic sentiments for the future while remaining grounded in the available evidence for a drug class that has the potential to revolutionize dermatologic care.