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JAK inhibitors in the treatment of atopic dermatitis
Journal of Allergy and Clinical Immunology ( IF 11.4 ) Pub Date : 2021-08-24 , DOI: 10.1016/j.jaci.2021.08.009
Raj Chovatiya 1 , Amy S Paller 1
Affiliation  

Atopic dermatitis (AD) is a chronic inflammatory skin disorder associated with heterogenous presentation and often immense patient burden. Safe, targeted treatment options are currently limited. This 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, describes the use of topical and systemic Janus kinase (JAK) inhibitors in the treatment of AD. New topical JAK inhibitors 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. Delgocitinib ointment was recently approved in Japan for pediatric and adult AD. Oral JAK inhibitors include baricitinib (JAK1/2), abrocitinib (JAK1-selective), and upadacitinib (JAK1-selective). All 3 met primary and secondary endpoints across numerous trials for moderate-to-severe AD. Treatment-emergent adverse events 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. JAK inhibitors 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.



中文翻译:

JAK抑制剂治疗特应性皮炎

特应性皮炎 (AD) 是一种慢性炎症性皮肤病,与异质性表现和通常巨大的患者负担有关。目前,安全、有针对性的治疗选择有限。这篇对已发表文献的重点回顾,包括临床试验结果、病例报告和摘要,以及来自科学会议的报告和来自行业新闻稿的数据,描述了局部和全身 Janus 激酶 (JAK) 抑制剂在治疗广告。新的外用 JAK 抑制剂包括 ruxolitinib (JAK1/2) 和 delgocitinib (pan-JAK)。Ruxolitinib 乳膏在轻度至中度 AD 的 3 期临床试验中达到了所有主要和次要终点,治疗中出现的不良事件最少。Delgocitinib 软膏最近在日本被批准用于儿童和成人 AD。口服 JAK 抑制剂包括 baricitinib (JAK1/2)、abrocitinib(JAK1 选择性)和 upadacitinib(JAK1 选择性)。在针对中度至重度 AD 的众多试验中,这 3 项均达到了主要和次要终点。治疗中出现的不良事件主要为轻度至中度,包括痤疮、恶心、头痛、上呼吸道感染,以及程度较轻的疱疹感染和选定的实验室异常。JAK 抑制剂作为下一代靶向 AD 疗法具有广阔前景。虽然它们出色的疗效与临床试验中良好的安全性相平衡,但仍需要真实世界的数据来更好地了解长期安全性、持久性和治疗成功率。治疗中出现的不良事件主要为轻度至中度,包括痤疮、恶心、头痛、上呼吸道感染,以及程度较轻的疱疹感染和选定的实验室异常。JAK 抑制剂作为下一代靶向 AD 疗法具有广阔前景。虽然它们出色的疗效与临床试验中良好的安全性相平衡,但仍需要真实世界的数据来更好地了解长期安全性、持久性和治疗成功率。治疗中出现的不良事件主要为轻度至中度,包括痤疮、恶心、头痛、上呼吸道感染,以及程度较轻的疱疹感染和选定的实验室异常。JAK 抑制剂作为下一代靶向 AD 疗法具有广阔前景。虽然它们出色的疗效与临床试验中良好的安全性相平衡,但仍需要真实世界的数据来更好地了解长期安全性、持久性和治疗成功率。

更新日期:2021-10-06
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