JAK inhibitors in the treatment of atopic dermatitis.

Abstract Atopic dermatitis is a chronic inflammatory skin disorder associated with heterogenous presentation and often immense patient burden. Safe, targeted treatment options are currently limited. We conducted a focused review of the published literature, including clinical trial results, case reports, and abstracts, as well as presentations from scientific meetings and data from industry press releases, to describe the use of topical and systemic janus kinase (JAK) inhibitors (JAKi) in the treatment AD. New topical JAKi include ruxolitinib (JAK1/2) and delgocitinib (pan-JAK). Ruxolitinib cream met all primary and secondary endpoints in phase 3 clinical trials for mild-to-moderate AD with minimal treatment-emergent adverse events (TEAEs). Delgocitinib ointment was recently approved in Japan for pediatric and adult AD. Oral JAKi include baricitinib (JAK1/2), abrocitinib (JAK1-selective), and upadacitinib (JAK1-selective). All three met primary and secondary endpoints across numerous trials for moderate-to-severe AD. TEAEs were mainly mild-to-moderate and included acne, nausea, headache, upper respiratory tract infection, and to a lesser degree, herpes infection and selected laboratory abnormalities. JAKi hold great promise as the next generation of targeted AD therapy. While their outstanding efficacy is balanced by a favorable safety profile in clinical trials, real-world data are needed to better understand long-term safety, durability, and treatment success.