Treatment of Atopic Dermatitis Using JAK Inhibitors: A Systematic Review

• Main Authors: Stefan Siedlikowski (Author), Vijay Sandhu (Author), Charles Lynde (Author)
• Format: Book
• Published: European Medical Journal, 2019-11-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2054-6211
• Keywords: atopic dermatitis (ad); eczema; jak; jak inhibitor (jaki); jak-stat; Dermatology; RL1-803
• Source: European Medical Journal Dermatology, Vol 7, Iss 1, Pp 89-100 (2019)

Background: The advent of JAK inhibitors (JAKi) has significantly modernised the treatment of atopic dermatitis (AD), offering a novel approach to treating this recalcitrant dermatological condition. Although topical treatment is shown to be effective, oral formulations are yet to be widely utilised in the treatment of AD. Objectives: To review the efficacy, safety, and tolerability of JAKi in the treatment of AD. Methods: A PRISMA systematic review of several databases was conducted: Cochrane Skin Specialised Register, Cochrane Central Register of Controlled Trials, Ovid Medline and Embase, LILACS, and Global Resource of EczemA Trials. Five clinical trial archives were also consulted. The following resources were manually searched: conference proceedings of the American Academy of Dermatology (AAD), FDA.gov, the European Medicines Agency (EMA), and Epistemonikos. Results: Of the 34 articles meeting inclusion criteria, 6 were chosen for final qualitative review. A total of 827 patients were pooled from 5 randomised controlled trials and 1 cohort study. Improvements in objective and subjective scoring indices were observed in patients receiving topical or oral JAKi. Overall safety and tolerability were satisfactory in JAKi treatment. Limitations: Due to the scarcity of randomised controlled trials and the small sample sets in the studies, a meta-analysis was not conducted. Conclusions: Preliminary investigations show promising results for patients with AD treated with oral or topical JAKi. However, existing gaps should be addressed with more extensive and long-term trials before JAKi become a standard treatment for AD.