JAK Inhibitors for Eczema

What are oral JAK inhibitors?

Oral JAK (Janus kinase) inhibitors, such as abrocitinib (Cibinqo) and upadacitinib (Rinvoq), are a class of medications that target specific immune pathways involved in various diseases. In dermatology, these drugs are primarily approved for conditions like atopic dermatitis (eczema) and psoriatic arthritis. Their efficacy is notable, often showing rapid control of symptoms. They are generally considered when other treatments, such as topical and oral steroids or other biologics like dupilumab, have failed to provide adequate control. Beyond their current indications, JAK inhibitors are also in use for other dermatological conditions like vitiligo and alopecia areata.

What are possible side effects of oral JAK inhibitors?

Oral JAK inhibitors carry multiple side effects due to their immunomodulatory action. They can increase the risk of infections, requiring temporary discontinuation of the medication for the immune system to combat any active infection. They may also lead to elevations in cholesterol levels and can impact liver and kidney function. Periodic blood work is essential to monitor these parameters, as well as blood cell counts. These medications also come with an elevated risk of blood clots, cardiovascular events, and certain types of cancer that may be kept at bay by a normally functioning immune system. More common side effects include nausea and acne.

How are oral JAK inhibitors used?

Oral JAK inhibitors are generally administered once daily in pill form. Given the range of potential side effects, a thorough medical evaluation is essential before starting this medication. This often includes a detailed discussion about the risks and benefits, as well as frequent monitoring through blood tests.