JAK Inhibitors as Flexible, Fast-Acting Option for Refractory AD

“JAK inhibitors have really given us additional options for therapy in the last few years that we didn't have for our patients, particularly oral therapeutics, something that's been lacking in this disease space,” said Raj Chovatiya, MD, PhD, MSCI, in an interview with Dermatology Times.

Chovatiya, a board-certified dermatologist and clinical associate professor at the Rosalind Franklin University Chicago Medical School, founder and director of the Center for Medical Dermatology and Immunology Research in Chicago, and a Dermatology Times Editorial Advisory Board member, discussed the clinical advantages of JAK inhibitors for atopic dermatitis (AD), emphasizing their efficacy, dosing flexibility, and role as a personalized treatment option for patients with inadequate response to prior therapies.

As Chovatiya noted in his interview, JAK inhibitors have significantly expanded the therapeutic options for AD, particularly in the realm of systemic oral treatments. Chovatiya highlighted their impact as a long-awaited option for patients who either require flexibility in treatment or have not responded adequately to conventional therapies. JAK inhibitors provide a unique combination of efficacy, rapid onset of action, and adjustable dosing regimens—traits that are particularly valuable in real-world clinical settings.

Current FDA-approved JAK inhibitors for AD include oral abrocitinib (Cibinqo; Pfizer) and upadacitinib (Rinvoq; AbbVie), and topical ruxolitinib (Opzelura; Incyte).

Chovatiya discussed the importance of a patient-specific, case-by-case approach when considering JAK inhibitors. Ideal candidates may include both treatment-naive individuals and those who have failed prior therapies. The key, he noted, is a balanced, transparent discussion with patients about potential benefits versus risks. For many, JAK inhibitors offer the possibility of significant improvement in pruritus and lesion burden, and the ability to tailor dose intensity can help align therapeutic outcomes with individual disease severity and lifestyle factors.

A practical advantage in clinical use is the capacity for dose modulation—intensifying treatment during flares or tapering when disease control is achieved. However, clinicians must communicate the need for initial laboratory monitoring and counsel on the low but notable risks of adverse effects, such as infection or thromboembolic events. Despite the typically low potential for adverse effects, Chovatiya reiterated the overall favorable safety profile of JAK inhibitors when appropriately selected and monitored.

Ultimately, JAK inhibitors represent a valuable, modern addition to the clinician’s toolbox by offering both clinical flexibility and efficacy in managing complex AD, particularly for patients seeking rapid and meaningful symptom relief.

To hear more about JAK inhibitor selection from Chovatiya, register to attend the 2025 Revolutionizing Atopic Dermatitis (RAD) Annual Meeting in Nashville, Tennessee, held June 6-7. Use code DT40 for 40% off your registration.