Atopic dermatitis (AD), also known as atopic eczema, is a chronic, pruritic, relapsing inflammatory dermatological condition. The condition usually begins during early infancy and childhood, but can persist into, or start during, adulthood. AD usually fluctuates between periods of relative flares and quiescence; however, some individuals have chronically active disease. The exact cause of the disease is unknown; however, certain factors such as epigenetic, genetic, immunological, and environmental interactions with overlapping skin barrier defects are indicated in its pathogenesis.
Recently, oral Janus kinase (JAK) inhibitors have been approved for use in treating patients with arthritis. Signaling proteins linked to cytokine receptors modulate the expression of thousands of genes associated with inflammatory processes. JAK inhibition is not restricted to systemic administration but has also been developed as a topical treatment option.
- How do you view a topical JAK inhibitor fitting into the treatment algorithm?
- Does the route of administration curb any concerns of side effects from a potential class effect?
The oral JAK inhibitors may soon get approval, but many of their side effects are concerning. Opzelura's side effect profile looks much better, although notably it's recommended not to use alongside other biologic medicines. I'll have to investigate what the concern would be if it's used in a patient on Dupixent.