Dr Jonathan Silverberg on the potential benefits and challenges of using JAK inhibitors in atopic dermatitis
Jonathan Silverberg, MD, PhD, MPH, Associate Professor of Dermatology, Director of Clinical Research and Patch Testing, George Washington University School of Medicine and Health Sciences, explains the efficacy and safety implications of using the JAK inhibitors for atopic dermatitis.
The potential of JAK inhibitors to block multiple pathways associated with atopic dermatitis could lead to better treatment efficacy, but may also pose safety concerns such as off-target effects, said Jonathan Silverberg, MD, PhD, MPH, Associate Professor of Dermatology, Director of Clinical Research and Patch Testing, George Washington University School of Medicine and Health Sciences.
What are the advantages and disadvantages of JAK inhibitors for atopic dermatitis?
At a very high level, the potential for blocking multiple pathways may be accompanied by potentially better efficiency. And we have certainly seen that at higher doses, where higher doses, pespecially upadacitinib and abrocitinib really set the bar for effectiveness in the field, period.
On the other hand, by targeting more mechanisms, more pathways, there may be more potential safety issues, as we are not just blocking one aspect of our immune system, but several aspects. And when it comes to small molecules and oral agents, there is also the potential for off-target effects, which can occur in the event that things that go beyond cytokines and signals that we may want to inhibit can also potentially occur.
So I think at a high level these are the pros and cons. There are, of course, many other potential nuances in terms of speed of effect and expediency for oral agents and some of the other things that come up that can be class highlights as well.