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

At the 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 HCPLive team at the presentation.

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