William Damsky, MD, PhD: Safety Profile for JAK Inhibitors in Dermatology

During another segment of his HCPLive interview, Damsky explained research from his presentation at the American Academy of Dermatology (AAD) 2023 Annual Meeting in New Orleans this week.

He serves as Assistant Professor of Dermatology at the Yale School of Medicine, his primary focus being translational research in immunologically mediated skin diseases.

After his discussion about granuloma annulare and sarcoidosis—the conditions covered in his portion of the shared presentation—Damsky described some of the other conditions treated by JAK inhibitors in recent studies.

“As many of the viewers may know, we now have our first FDA-approved drug in the United States for alopecia areata, which is baricitinib,” he explained. “We also have 2 oral JAK inhibitors and 1 topical JAK inhibitor, which are, I think, all new since last year's AAD, which are now approved in atopic dermatitis…And excitingly, deucravacitinib, which is a TYK2 inhibitor, so one of the JAK proteins, is now approved for psoriasis.”

Damsky then went into a discussion about common safety concerns with JAK inhibitors, compared to more conventional dermatologic therapies.

“So I would say JAK inhibitors are safe,” he said. “I have a lot of patients on JAK inhibitors and really have seen remarkable improvement in patients that really had failed to control their, oftentimes, severe skin disease with other available agents.”

He further added that frank discussions with patients on potential side effects should take place, making the use of JAK inhibitors a shared decision process.

“The black box warnings are based on a study done in rheumatoid arthritis patients taking tofacitinib either 5 or 10 milligrams twice daily, and all patients were also taking prednisone,” he said. “All patients were older and had cardiovascular risk factors and many of the patients were taking prednisone.”

He noted that the rare side effects observed in this group were major adverse cardiovascular events, malignancy, thrombosis and infection.

“So we know how tofacitinib compares to TNF alpha inhibitors in patients with RA,” he said. “Also…what we don't know is, in patients that don't really have another option who are treated with these therapies, what their long term outcome is for them without treatment. It's a discussion that's very nuanced.”

For more information about the topics covered in Damsky’s presentation, view the HCPLive interview above.