JAK Inhibitors for Atopic Dermatitis

Medically Reviewed by Stephanie S. Gardner, MD on March 06, 2024
3 min read

Scientists continue to discover treatments for atopic dermatitis, the most common form of the skin condition eczema. They’ve learned that JAK inhibitors, once reserved for other illnesses, also help soothe itchy, sensitive, swollen skin triggered by atopic dermatitis. Here’s more about this treatment.

Janus kinase (JAK) inhibitors are part of a class of medicines called disease-modifying antirheumatic drugs (DMARDs). These drugs curb your immune system. Doctors prescribe JAK inhibitors for inflammatory conditions like rheumatoid arthritis and psoriatic arthritis. The FDA began approving JAK inhibitors to treat atopic dermatitis in 2022.

Experts think cytokines, proteins made by your immune system, may be partly to blame for atopic dermatitis. Cytokines use the JAK signaling pathway to trigger inflammation. Like a valve on a faucet, JAK inhibitors block the pathway, limiting cytokines’ effects.

These medications work quickly to ease itching, inflammation, and other symptoms. If you’ve had trouble controlling your condition with other prescription drugs, JAK inhibitors might work for you.

The FDA has approved three JAK inhibitors for atopic dermatitis:

Abrocitinib (Cibinqo). This tablet is for adults with refractory, moderate to serious atopic dermatitis.

Ruxolitinib (Opzelura). This is a topical medicine, which means you put on your skin. This cream is a short-term treatment for people 12 and older with mild to moderate atopic dermatitis.

Upadacitinib (Rinvoq). This is a tablet for adults and children over age 12 with moderate to serious atopic dermatitis.

Researchers are studying other JAK inhibitors for atopic dermatitis.

Researchers rounded up 10 clinical studies on JAK inhibitors for treating atopic dermatitis. They wanted to know more about the safety of these drugs and how well they work. The studies included more than 3,200 people around the world with atopic dermatitis. Here are some of their findings:

The EASI score dropped. This measures how bad your atopic dermatitis symptoms are. A higher score means more serious symptoms.

Both oral and topical JAK inhibitors lowered EASI scores. This was usually around 2 to 4 weeks after starting the medication.

Topical JAK inhibitors may work better. They seem to have the biggest impact on moderate to severe atopic dermatitis.

Common, less serious side effects include:

  • Nausea
  • Indigestion
  • Diarrhea
  • Headaches

The FDA has issued a boxed warning (also called a “black box” warning) for some JAK inhibitors, including Cibinqo, Opzelura, and Rinvoq. This type of warning means these drugs could cause serious or even life-threatening side effects such as:

Infection. JAK inhibitors lower your immune system’s power to fight infections. You should also avoid taking JAK inhibitors if you have an active infection.

Cancer. These drugs raise your chances of getting lymphoma, skin, lung, and other forms of cancer. If you smoke now or have in the past, your odds of getting lung cancer are even higher.

Cardiovascular disease. You’re also more likely to have a heart attack, stroke, cardiac death, and blood clots in your leg veins or lungs.

Low blood cell counts. JAK inhibitors can trigger a drop in your platelet, red blood cell, and white blood cell counts.

Higher cholesterol. Your cholesterol may also rise while taking this medication in pill form.

Your doctor will want to know if you’ve ever had any of these conditions or if you’re pregnant or plan to get pregnant. Avoid breastfeeding while taking this medicine and for 1 month after your last dose.

Be sure to also tell your doctor about any prescription or over-the-counter medicines or supplements you take since JAK inhibitors can interact with some drugs.

If you have symptoms of a heart attack, stroke, or blood clots while taking a JAK inhibitor, call for help right away.