Background:
Atopic dermatitis (AD) is a common, often chronic relapsing inflammatory skin disorder that affects all age groups with an immense impact on patients’ quality of life. Safe, targeted, topical treatments are currently limited. Our knowledge of the pathophysiology and clinical burden of AD has rapidly evolved, leading to revolutionary new topical treatments with Janus kinase (JAK) inhibitors in the treatment of AD.
Methods:
This focused review of the published literature, including clinical trial results, case reports, and abstracts, provides an update on the efficacy and side effect profiles of the topical JAK inhibitors currently approved for use in the treatment of AD, as well as those in phase 2 and phase 3 clinical trials.
Results:
The first topical JAK inhibitor approved for clinical use in the treatment of AD was ruxolitinib in the USA. However, including tofacitinib, ifidanicitinib and delgocitinib, others are undergoing phase 2 and/or phase 3 studies and will likely be available for clinical use in the not-so-distant future. Ruxolitinib 1.5% cream is associated with reduction in itch, improvement in Investigator’s Global Assessment and higher rates of EASI-75 have been achieved when compared with the vehicle group. Topical JAK inhibitors have been well tolerated, with a low incidence of application site reactions and very few systemic adverse effects have been reported.
Conclusion:
AD treatment is undergoing a revolution where cutting edge laboratory research is being translated into new clinical applications. Clinical trials and post-marketing safety data have suggested that topical JAK inhibitors are highly efficacious in the targeted treatment of AD, well tolerated, and are without significant adverse systemic effects. However, this assessment is based on currently available short-term efficacy and safety profiles and may require updating when long-term safety data becomes available. In addition, their implementation and widespread acceptance will no doubt be influenced by costings.