JAK Inhibitors in Dermatology

JAK inhibitors usage is increasing in atopic dermatitis, alopecia areata, psoriasis, and vitiligo. Studies suggest that JAK inhibitors may have widespread utility in dermatology, with early reports of success in several other conditions. JAK inhibitors can be taken orally or applied topically and are a promising new type of medication.

Acne as a Side Effect

An Original Investigation published in JAMA Dermatology has identified higher rates of acne following treatment with a JAK inhibitor.

JAK inhibitors have shown promise as a treatment option for inflammatory conditions, but acne is a commonly reported side effect. However, there is limited information on the overall incidence of acne and how it varies between drug classes and underlying conditions. This study analyzed the risk of acne associated with JAK inhibitors across phase 2 and 3 placebo-controlled randomized clinical trials.

Study Methodology

To assess the incidence of acne in phase 2 and 3 placebo-controlled randomized clinical trials (RCTs) of JAK inhibitors, the present study team searched the Ovid MEDLINE and PubMed databases for studies published in English from January 31, 2023. Studies included reported adverse events of acne. Two reviewers independently reviewed and extracted information from all included studies. The primary outcome of interest was the incidence of acne following JAK inhibitor use. We conducted a meta-analysis using random-effects models to pool the data from all included studies.

Key Findings

• Twenty-five unique studies included 54% male and 46% female participants.
• The pooled odds ratio (OR) was calculated to be 3.83, with increased ORs for abrocitinib, baricitinib, upadacitinib, deucravacitinib, and deuruxolitinib.
• Estimated ORs were higher across studies investigating the use of JAK inhibitors for treating dermatologic than nondermatologic conditions, as well as for JAK1-specific inhibitors, combined JAK1 and JAK2 inhibitors, and tyrosine kinase two inhibitors.

They said in this study, we recorded the use of JAK inhibitors with elevated odds of acne. Patients should be appropriately counseled on the potential adverse effects of these medications before treatment initiation. Further studies are needed to characterize the underlying mechanism of acne with JAK inhibitor use and identify best treatment practices.

Conclusion

Janus kinase (JAK) inhibitors are increasingly used for many dermatologic conditions. Acne vulgaris negatively impacts self-esteem, mental well-being, and social functioning. Furthermore, the potential for developing acne following treatment with JAK inhibitors is a concern, as this adverse effect may cause some patients to hesitate in adhering to their treatment plan.

Reference

Martinez J, Manjaly C, Manjaly P, et al. Janus Kinase Inhibitors and Adverse Events of Acne: A Systematic Review and Meta-Analysis. JAMA Dermatol. Published online October 18, 2023. doi:10.1001/jamadermatol.2023.3830