Mastering the Use of Systemic JAK Inhibitors for Atopic Dermatitis: A Dermatologist's Practical Guide

Atopic dermatitis (AD) is one of the most frequent conditions treated by dermatologists. The therapeutic options for moderate-to-severe AD are rapidly expanding with the introduction of biologics and Janus kinase inhibitors (JAKis). There are currently three oral JAKis approved for the treatment of AD, namely abrocitinib, baricitinib and upadacitinib. Although JAKis are rapidly effective for treating AD and its symptoms, they require careful patient selection and monitoring due to a side-effect profile which includes an increased risk of major adverse cardiovascular events (MACE) and malignancies, especially in patients with pre-existing risk factors. The aim of this article is to provide practical recommendations on how to prescribe, monitor and manage potential adverse reactions of systemic JAKis for AD, and to assist dermatologists in navigating various scenarios that can be encountered in clinic.