Gargiulo Luigi, Ibba Luciano, Malagoli Piergiorgio, Burroni Anna G, Chiricozzi Andrea, Dapavo Paolo, Ferrucci Silvia M, Gola Massimo, Napolitano Maddalena, Ortoncelli Michela, Rossi Maria T, Sciarrone Claudio, Costanzo Antonio, Narcisi Alessandra
Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Dermatol Ther (Heidelb). 2024 Apr;14(4):919-932. doi: 10.1007/s13555-024-01135-x. Epub 2024 Mar 21.
Several systemic therapies have been approved for the treatment of severe AD. In particular, Janus kinase inhibitors (JAKi), including abrocitinib, baricitinib, and upadacitinib, recently received approval for the treatment of patients with severe AD after being evaluated in several clinical trials. However, a few concerns have been raised regarding their long-term safety and the management of these drugs in real-world clinical practice. In this article we described the results of a Delphi consensus aimed at describing the knowledge on JAKi and focusing, in particular, on providing clinical recommendations for dermatologists in daily practice regarding the use of these drugs.
Twelve Italian dermatologists reviewed the most recent literature regarding the efficacy and safety profiles of JAKi and proposed 24 statements.
Agreement was reached for statements focusing on three main topics: (1) place in therapy of JAKi in patients with moderate-to-severe AD; (2) effectiveness and safety of JAK inhibitors in different phenotypes; (3) different approaches to the management of patients treated with JAKi in clinical practice. The panel proposed several recommendations regarding all the statements.
Given the wide use of JAKi in clinical practice, it is crucial to establish a specific follow-up for each patient's phenotype in order to achieve the best possible clinical outcome and minimize potential adverse events.
几种全身治疗方法已被批准用于治疗重度特应性皮炎(AD)。特别是,包括阿布昔替尼、巴瑞替尼和乌帕替尼在内的 Janus 激酶抑制剂(JAKi),在经过多项临床试验评估后,最近获得批准用于治疗重度 AD 患者。然而,人们对其长期安全性以及在实际临床实践中这些药物的管理提出了一些担忧。在本文中,我们描述了一项德尔菲共识的结果,旨在阐述关于 JAKi 的知识,尤其着重为皮肤科医生在日常实践中使用这些药物提供临床建议。
12 名意大利皮肤科医生回顾了关于 JAKi 疗效和安全性的最新文献,并提出了 24 条陈述。
就聚焦于三个主要主题的陈述达成了共识:(1)JAKi 在中度至重度 AD 患者治疗中的地位;(2)JAK 抑制剂在不同表型中的有效性和安全性;(3)临床实践中对接受 JAKi 治疗患者的不同管理方法。该小组针对所有陈述提出了若干建议。
鉴于 JAKi 在临床实践中的广泛应用,为每个患者的表型建立特定的随访至关重要,以便实现最佳临床结果并将潜在不良事件降至最低。