JAK in the [Black] Box: A Dermatology Perspective on Systemic JAK Inhibitor Safety

Am J Clin Dermatol. 2022 Jul;23(4):427-431. doi: 10.1007/s40257-022-00701-3. Epub 2022 Jun 9.

Abstract

Janus kinase (JAK) inhibitors are immunomodulatory agents with broad potential for use within dermatology. However, the US Food and Drug Administration has recently placed additional warning labels on JAK inhibitors given concern for an increased risk of major adverse cardiovascular events, malignancy, venous thromboembolism, and mortality. Here, we summarize recent efficacy and safety data of multiple JAK inhibitors including tofacitinib, upadacitinib, baricitinib, and abrocitinib. JAK inhibitors have high efficacy in treating psoriatic arthritis and atopic dermatitis, but carry an increased risk of venous thromboembolism and cardiovascular events relative to other approved treatments. Here, we provide current considerations on balancing the benefits of JAK inhibitors with potentially serious, but low-absolute risk, safety concerns.

MeSH terms

  • Arthritis, Rheumatoid* / chemically induced
  • Arthritis, Rheumatoid* / drug therapy
  • Dermatitis, Atopic* / drug therapy
  • Dermatology*
  • Humans
  • Janus Kinase Inhibitors* / adverse effects
  • Venous Thromboembolism* / chemically induced
  • Venous Thromboembolism* / drug therapy

Substances

  • Janus Kinase Inhibitors