Mona Shahriari, MD, FAAD

Evaluation of Long-Term Data With JAK Inhibitors

Video content above in prompted by the following:

The JADE EXTEND study looked at abrocitinib use in patients who had previously taken dupilumab (Shi 2022). In your experience, does a patient’s positive response to one therapeutic suggest they will also be responsive to a different therapeutic? Similarly, do you find that nonresponders to one therapeutic also are nonresponders to other therapeutics?

In patients who achieved an EASI-75 response with dupilumab, 83/92 (90.2%) achieved EASI-75 with 100 mg abrocitinib and 43/46 (93.5%) achieved EASI-75 with 200 mg abrocitinib after 12 weeks.

In patients who did not achieve an EASI-75 response with dupilumab, 21/31 (67.7%) achieved EASI-75 with 100 mg abrocitinib and 16/20 (80.0%) achieved EASI-75 with 200 mg abrocitinib after 12 weeks.

AEs included nasopharyngitis, nausea, acne, and headache.

Videos

Panelists discuss how the JADE EXTEND study (Shi 2022) found that most patients who achieved EASI-75 with dupilumab also responded to abrocitinib. Even some dupilumab nonresponders achieved EASI-75. Adverse events (AEs) included nausea, acne, and headache.

JADE COMPARE: Considerations for Comparisons Among Systemic Agents in Atopic Dermatitis

Discuss the JADE COMPARE study, where abrocitinib was compared to a placebo and dupilumab (Bieber 2021). When would you recommend a Janus kinase inhibitor over a biologic?

71.0% of the 221 patients taking 200 mg abrocitinib and 60.3% of the 229 patients taking 100 mg abrocitinib achieved EASI-75 response at week 16.

65.5% of the 232 patients taking dupilumab achieved EASI-75 response at week 16.

There was no significant difference in EASI-75 response between patients taking abrocitinib (with either dose) and those taking dupilumab.

Nausea and acne were more common in the abrocitinib patients than in the dupilumab patients; conjunctivitis was more common in the dupilumab patients.

4.4% of patients taking 200 mg abrocitinib, 2.5% of patients taking 100 mg abrocitinib, and 3.3% of patients taking dupilumab withdrew due to an AE.

Panelists discuss how the JADE COMPARE study (Bieber 2021) found similar EASI-75 response rates at 16 weeks for abrocitinib (71.0% at 200 mg, 60.3% at 100 mg) and dupilumab (65.5%). Abrocitinib had more nausea/acne; dupilumab had more conjunctivitis. Adverse effect (AE) withdrawal rates were low.

Safety Protocols With JAK Inhibitors

Discuss the Measure Up 1 and 2 studies (upadacitinib) (Simpson 2022). Do you see similar results in patients who take upadacitinib in your practice? When do you recommend this treatment?

At 52 weeks, 82.0% and 79.1% of patients taking 15 mg upadacitinib achieved EASI-75, in Measure Up 1 and 2 respectively.

At 52 weeks, 84.9% and 84.3% of patients taking 30 mg upadacitinib achieved EASI-75, in Measure Up 1 and 2, respectively.

The most common AEs were acne, cough, headache, herpes zoster, and creatine kinase elevation

4.5% of patients taking 15 mg upadacitinib withdrew due to AEs.

7.2% of patients taking 30 mg upadacitinib withdrew due to AEs.

Panelists discuss how the Measure Up 1 and 2 studies (Simpson 2022) showed that at 52 weeks, 82.0% to 84.9% of upadacitinib patients achieved EASI-75. Common adverse effects (AEs) included acne, cough, and headache, with 4.5% to 7.2% withdrawal rates.

Rapid Efficacy and Safety Considerations With the Use of JAK Inhibitors in Atopic Dermatitis Care

How have JAK inhibitors (upadacitinib, abrocitinib, baricitinib) changed the treatment of moderate to severe atopic dermatitis, and in what ways to they differ from traditional biologics in terms of administration, safety, and efficacy?

Panelists discuss how Janus kinase (JAK) inhibitors such as upadacitinib, abrocitinib, and baricitinib offer rapid, oral treatment for moderate to severe atopic dermatitis, differing from injectable biologics in administration, broader immunosuppression, and risk of adverse events like thromboembolism. They provide effective symptom control but require safety monitoring.

Mona Shahriari, MD, FAAD

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