Dr Jonathan Silverberg Lists Which Patients With AD Benefit Most From JAK Inhibitors

Jonathan Silverberg, MD, PhD, MPH, discusses how Janus kinase (JAK) inhibitors are used to treat patients with atopic dermatitis (AD) and which patients could benefit from them most. Silverberg is a professor of dermatology and director of clinical research and patch testing at the George Washington University School of Medicine and Health Sciences.

Transcript

How have JAK inhibitors changed the AD landscape since their FDA approval? What are patient perspectives on the safety and accessibility of JAK inhibitors?

A lot is happening now in the JAK inhibitor space. We are seeing a tremendous amount of additional data coming out in terms of post hoc analysis from the trials, and real world studies now, and exploration of new indications beyond atopic dermatitis or new subsets of the patients within atopic dermatitis; it's definitely a lot happening.

I think, first and foremost, JAK inhibitors offer us a new treatment option to reach those who've already had an inadequate response or adverse events to a prior systemic therapy; in the United States, that would be the on-label use. For some patients, they [JAK inhibitors] are the appropriate first-line systemic therapy to be considering in different clinical scenarios. For many patients where injections are just not preferred or ideal, having an oral option that's highly effective is truly welcome.

We have certainly seen an expansion of our toolbox for managing patients with atopic dermatitis, but we're starting now to understand additional subsets of patients that may benefit from JAK inhibitors, in particular that may not even be so appropriate for biologics. Perhaps patients with more seasonal, or intermittently severe, disease where use of a biologic doesn't really make so much sense in those patients with less chronic disease. Potentially, for patients who have much more fluctuating disease where sometimes they need a little more medicine to get them through a tough flare, a little less for flare prevention, we're seeing opportunities for dose flexibility.

Our whole paradigm is really starting to shift now with JAK inhibitors, and I think we have to figure out how we can best incorporate them into the overall approach of trying to achieve long-term control in the disease, but they're really giving us a whole new approach for how to do that.