Systematic Review on the Efficacy and Safety of Oral Janus Kinase Inhibitors for the Treatment of Atopic Dermatitis.

Abstract

Background: Atopic dermatitis is a chronic, relapsing and remitting disease that can be difficult to treat despite a recently approved biologic therapy targeting IL-4/IL-13 receptor. Oral janus kinase inhibitors (JAKi) represent a novel therapeutic class of targeted therapy to treat moderate-to-severe atopic dermatitis (AD). Objective: To review the efficacy, safety, and pharmacokinetic characteristics of oral JAKi in the treatment of AD. Methods: A PRISMA systematic review was conducted using MEDLINE, EMBASE (Ovid), and PubMed databases for studies assessing the efficacy, safety, and/or pharmacokinetic properties of oral forms of JAKi in the treatment of AD in pediatric or adult populations from inception to June 2021. Results: 496 papers were reviewed. Of 28 articles that underwent full text screening, 11 met our inclusion criteria for final qualitative review. Four studies examined abrocitinib; three studies examined baricitinib; three examined upadacitinib and one examined gusacitinib (ASN002). Significant clinical efficacy and a reassuring safety profile was reported for all JAKi agents reviewed. Rapid symptom control was reported for abrocitinib, baricitinib and upadacitinib. Limitations: Given the relatively limited evidence for each JAKi and the differences in patient eligibility criteria between studies, the data was not deemed suitable for a meta-analysis at this time. Conclusion: Given their ability to achieve rapid symptom control with a reassuring safety profile, we recommend considering the use of JAKi as a reliable systemic treatment option for adult patients with moderate-to-severe AD, who are unresponsive to topical or skin directed treatments.

• Authors: Michelle Le, Melissa Berman-Rosa, Feras M Ghazawi, Marc Bourcier, Loretta Fiorillo, Melinda Gooderham, Lyn Guenther, Sameh Hanna, H Chih-Ho Hong, Ian Landells, Perla Lansang, Danielle Marcoux, Marni C Wiseman, Jensen Yeung, Charles Lynde, Ivan V Litvinov
• Journal: Frontiers in medicine (Front Med (Lausanne)) Vol. 8 Pg. 682547 ( 2021) ISSN: 2296-858X [Print] Switzerland
• PMID: 34540860 (Publication Type: Systematic Review)
• Copyright: Copyright © 2021 Le, Berman-Rosa, Ghazawi, Bourcier, Fiorillo, Gooderham, Guenther, Hanna, Hong, Landells, Lansang, Marcoux, Wiseman, Yeung, Lynde and Litvinov.