Tina Bhutani, MD

Data on JAK Inhibitor Safety for Those Pregnant or Breastfeeding, with Tina Bhutani, MD

American Academy of Dermatology (AAD) Annual Meeting

 in Orlando, a presentation titled ‘Alopecia Areata: New Therapies’ featured University of California, San Francisco clinical researcher Tina Bhutani-Jaqcues, MD, who spoke with the 

The topic of Janus Kinase (JAK) inhibitors and guidance on implementation among patients with 

 during pregnancy or breastfeeding was highlighted by Bhutani in her interview. Bhutani was asked about some of the biggest takeaways from the talk at AAD.

“I encourage, if you do have a patient who for whatever reason does become pregnant while on these medications or decides that they still want to breastfeed, despite the limited amount of data, to actually report this to the to the FDA and the company at large, so that we can track this data,” Bhutani said. “There are also registries. There's a registry called ‘MotherToBaby,’ and they track the effects of medications on pregnancy and lactation. So using those kinds of resources can help others, help to increase the numbers of patients that we have, and increase our confidence in using these medications in this population.”

Bhutani also highlighted several unique findings covered in her talk regarding JAK inhibitors and birth control among women.

“The other concern that comes up when we're treating women of reproductive potential is the question about birth control,” Bhutani said. “So we know that, for example, oral contraceptive pills can increase clotting risk in some patients, especially women who are age over the age of 35, especially if they're smokers and things of that sort. One of the concerns in that black box warning was the risk of venous thromboembolism or blood clots. So the question becomes if we combine JAK inhibitors with birth control, is that a double hitter, and are these women going to be at increased risk for blood clots? And the answer is actually no, not from the data that we see.”

Bhutani noted that these types of findings contribute to the safety profile of JAK inhibitors used for alopecia areata. She highlighted research on rheumatoid arthritis during which patients were allowed to continue birth control, with the results indicating that the risk of venous thromboembolism was not increased.

Later, Bhutani was asked about additional studies she highlighted in her talk. She noted an additional analysis that she felt was worth mentioning.

“I think one unique thing that [also] I found was that for deucravacitinib…in the animal studies, [investigators] actually didn't see any issues with the drug either crossing into the placenta or causing any abnormalities,” Bhutani said. “So I think it just it begs the question ‘Should it really be in the JAK family’ and ‘Is it a different type of protein?’”

For additional information on this topic, view the full video interview posted above.

The quotes contained in this summary were edited for the purposes of clarity.

Videos

This AAD 2025 interview with Bhutani covers some of the takeaways from her presentation on use of JAK inhibitors for alopecia areata among pregnant or breastfeeding women.

A talk titled ‘Alopecia Areata: New Therapies’ was held at the 

2025 American Academy of Dermatology (AAD) Annual Meeting

 in Orlando, during which Tina Bhutani-Jaqcues, MD, is speaking on the topic of Janus Kinase (JAK) inhibitors and data on use with 

Bhutani is a board-certified dermatologist, a fellow of the AAD, and a clinical researcher at the University of California, San Francisco. Bhutani spoke in an interview with 

 at AAD 2025 regarding her talk’s biggest takeaways for clinicians who are curious about JAK inhibitor safety during pregnancy.

Guidance on JAK Inhibitors for Alopecia Areata During Pregnancy

Guidance on JAK Inhibitors for Alopecia Areata During Pregnancy, with Tina Bhutani, MD

“This was a talk that I was invited to give at the alopecia areata forum, and the reason for that is that we're using a lot of JAK inhibitors, not only for alopecia areata, but also for other diseases like atopic dermatitis,” Bhutani explained. “Unlike other disease states, where our patients might be older or lactation might not be of concern, patients with alopecia areata and atopic dermatitis are actually younger. So these questions and these considerations are going to come into play, and we're probably going to have to have these conversations more often.”

Bhutani highlighted several key points from her portion of the presentation, noting that she reviewed the little data available on JAK inhibitor use during pregnancy. In light of this research, Bhutani stressed caution.

“In most of the data that is available on the use of JAK inhibitors in pregnancy, it had to do with animal studies, because that’s where most of the data comes from,” Bhutani said. “Unfortunately, the animal studies do show that at very, very high doses of JAK inhibitors, much higher doses than what we use in humans, there is a chance for for spontaneous abortion and for congenital abnormalities. So there does seem to be a concern when it comes to animal studies.”

Bhutani highlighted additional data on upadacitinib and baracitinib for atopic dermatitis and alopecia, respectively, noting that these are the currently approved JAK inhibitors.

“There were actually some cases of patients who did become pregnant in these trials,” Bhutani said. “I looked at the data, not only in dermatology, but actually looking at cases in inflammatory bowel disease and other indications where these drugs are used, to compile all the statistics. Luckily, it shows that the rate of spontaneous abortions and the rates of congenital abnormalities that were seen in those patients are pretty similar to the general population. So even though at much higher doses in animals, we did see problems, when we look at just the normal doses of these medications in the human population, so far, there doesn't seem to be many red flags.”

However, Bhutani noted that recommendations are still to try and stop these medications before trying to become pregnant. She also noted data on breastfeeding data.

“We don't have much data when it comes to breastfeeding on these drugs,” Bhutani said. “But again, the animal studies do show that the medication seems to pass through breast milk, so it is probably not recommended to breastfeed while taking these medications.”

For additional information on this subject, view Bhutani’s full interview segment posted above. To learn more from AAD 2025, view our 

The quotes used in this interview summary were edited for clarity.

In this interview at AAD 2025, Bhutani highlights several points of consideration for clinicians treating patients who are pregnant and suffering from alopecia areata.

Dermatologists Drs Tina Bhutani and Scott Boswell and patient Kanya Oul share resources and tools available to cope with generalized pustular psoriasis (GPP).

Tips for Managing Generalized Pustular Psoriasis (GPP)

This is a video synopsis/summary of a panel discussion involving Tina Bhutani, MD; J. Scott Boswell, MD; and Kanya Oul, RN.

In the concluding segment of the discussion, Kanya emphasizes the importance of healthcare providers listening to their patients and believing their experiences. She credits her doctor with saving her life and underscores the significance of finding a reliable healthcare provider who understands the patient's condition. Kanya encourages providers to educate themselves and be proactive in referring patients for appropriate care.

The speaker echoes the importance of education, stressing the need for healthcare professionals to stay updated on advancements in their field. He emphasizes the role of primary care physicians and emergency medicine practitioners in recognizing and treating severe skin conditions like generalized pustular psoriasis (GPP). The speaker shares his proactive approach to adopting new treatments for the benefit of his patients.

Overall, the discussion highlights the importance of patient-provider communication, education, and collaboration in effectively managing conditions like GPP. The participants express gratitude for the opportunity to share their insights, underscoring the value of such discussions in improving patient care.

Video synopsis is AI-generated and reviewed by HCPLive editorial staff.

Coping With and Support for Generalized Pustular Psoriasis (GPP)

The conversation delves into coping mechanisms for dealing with autoimmune diseases, particularly psoriasis. Kanya shares her personal journey of learning to cope with the condition since childhood, highlighting the importance of social support from friends and family. She emphasizes the lack of formal therapy in her upbringing due to various factors but acknowledges the value of seeking support as an adult.

The speaker underscores the systemic nature of psoriasis and the need for comprehensive patient care beyond just treating the skin. He discusses strategies for assessing the impact of the disease on patients' lives, including open communication about symptoms and the benefits of treatment. The discussion also touches on the challenges of finding accurate information and support resources, with emphasis on the role of healthcare providers in guiding patients to evidence-based resources.

Overall, the conversation underscores the importance of social support, accurate information, and comprehensive care in managing autoimmune diseases like psoriasis. It highlights the need for healthcare providers to address the mental health impact of these conditions and guide patients to appropriate support resources.

Tina Bhutani, MD

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