From the Department of Dermatology, St. Luke's University Health Network, Easton, Pennsylvania, USA.
Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Dermatitis. 2024 Jan-Feb;35(S1):S24-S38. doi: 10.1089/derm.2023.0058. Epub 2023 Aug 1.
Recently, 3 oral Janus kinase (JAK) inhibitors-abrocitinib, baricitinib, and upadacitinib-were approved in many regions around the world for the treatment of moderate-severe atopic dermatitis (AD). These JAK inhibitors generally have rapid onset of action and short half-life. Higher doses of abrocitinib and upadactinib even demonstrated superior efficacy to dupilumab. However, JAK inhibitors can be associated with rare serious and potentially life-threatening adverse events. Heterogeneity in study designs and lack of head-to-head studies make safety comparison between JAK inhibitors difficult. Dose reduction and patient selection are the most important considerations for risk mitigation. This narrative review examines the efficacy data for abrocitinib, baricitinib, and upadacitinib from large phase III double-blinded randomized controlled trials in AD and discusses risk stratification for oral JAK inhibitors in AD patients.
最近，3 种口服 Janus 激酶（JAK）抑制剂——阿布昔替尼、巴瑞替尼和乌帕替尼——在全球许多地区获得批准，用于治疗中重度特应性皮炎（AD）。这些 JAK 抑制剂通常具有快速的作用机制和较短的半衰期。更高剂量的阿布昔替尼和乌帕替尼甚至显示出比度普利尤单抗更优的疗效。然而，JAK 抑制剂可能与罕见的严重且潜在危及生命的不良事件相关。研究设计的异质性和缺乏头对头研究使得 JAK 抑制剂之间的安全性比较变得困难。剂量减少和患者选择是降低风险的最重要考虑因素。本综述性文章检查了阿布昔替尼、巴瑞替尼和乌帕替尼在 AD 中进行的大型 III 期双盲随机对照试验的疗效数据，并讨论了 AD 患者口服 JAK 抑制剂的风险分层。
