Janus kinase inhibitors in dermatology: A systematic review

J Am Acad Dermatol. 2017 Apr;76(4):745-753.e19. doi: 10.1016/j.jaad.2016.12.004. Epub 2017 Feb 4.

Abstract

Background: Janus kinase (JAK) inhibitors are emerging as a promising new treatment modality for many inflammatory conditions.

Objective: Our aim was to systematically review the available data on the use of JAK inhibitors in cutaneous diseases.

Methods: This is a systematic review of PubMed and ClinicalTrials.gov.

Results: One hundred thirty-four articles matched our search terms, of which 78 were original articles and 12 reports on adverse events. Eighteen clinical trials were found. JAK inhibitors have been extensively studied for psoriasis, showing beneficial results that were comparable to the effects achieved by etanercept. Favorable results were also observed for alopecia areata. Promising preliminary results were reported for vitiligo, dermatitis, graft versus host disease, cutaneous T cell lymphoma, and lupus erythematosus. The most common adverse events reported were infections, mostly nasopharyngitis and upper respiratory tract infections.

Limitations: It was not possible to perform a meta-analysis of the results.

Conclusions: This systematic review shows that while JAK inhibitors hold promise for many skin disorders, there are still gaps regarding the correct dosing and safety profile of these medications for dermatologic indications. Additional trials are necessary to address these gaps.

Keywords: JAK inhibitors; alopecia areata; atopic dermatitis; baricitinib; dermatology; graft versus host disease; psoriasis; ruxolitinib; tofacitinib; vitiligo.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Alopecia Areata / drug therapy
  • Alopecia Areata / enzymology
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use*
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Azetidines / adverse effects
  • Azetidines / therapeutic use
  • Dermatologic Agents / adverse effects
  • Dermatologic Agents / therapeutic use*
  • Drug Eruptions / etiology
  • Humans
  • Janus Kinases / antagonists & inhibitors*
  • Molecular Targeted Therapy*
  • Nitriles
  • Piperidines / adverse effects
  • Piperidines / therapeutic use
  • Protein Kinase Inhibitors / adverse effects
  • Protein Kinase Inhibitors / therapeutic use*
  • Psoriasis / drug therapy
  • Psoriasis / enzymology
  • Purines
  • Pyrazoles / adverse effects
  • Pyrazoles / therapeutic use
  • Pyrimidines / adverse effects
  • Pyrimidines / therapeutic use
  • Pyrroles / adverse effects
  • Pyrroles / therapeutic use
  • Randomized Controlled Trials as Topic
  • Signal Transduction / drug effects
  • Skin Diseases / drug therapy*
  • Skin Diseases / enzymology
  • Sulfonamides / adverse effects
  • Sulfonamides / therapeutic use

Substances

  • Anti-Inflammatory Agents
  • Antineoplastic Agents
  • Azetidines
  • Dermatologic Agents
  • Nitriles
  • Piperidines
  • Protein Kinase Inhibitors
  • Purines
  • Pyrazoles
  • Pyrimidines
  • Pyrroles
  • Sulfonamides
  • ruxolitinib
  • tofacitinib
  • Janus Kinases
  • baricitinib