What Doctors Don't Know About Patient Experiences with JAK Inhibitors

Patient experiences with a newer class of medicines for chronic skin conditions remain "largely uninvestigated" despite their growing use, according to a September study published in Archives of Dermatological Research.

The study, led by Divya Sharma, M.D., of the University of Nebraska Medical Center, analyzed more than 900 posts from Reddit forums focused on several conditions treated by Janus kinase (JAK) inhibitors, including atopic dermatitis (AD) and vitiligo. For millions with these conditions, traditional treatments like topical steroids don't effectively manage symptoms, making JAK inhibitors an important treatment option. Despite their importance, patients’ concerns and experiences are not fully understood.

The researchers found nearly half (47%) of the posts focused on efficacy, while 16% discussed adverse effects such as acne, nausea and fatigue. Others raised issues about drug costs and insurance challenges, as well as other barriers patients face in accessing these therapies.

“This analysis highlights that patients are most concerned about the efficacy and side effects of JAK inhibitors in addition to issues regarding access to JAK inhibitors,” wrote Sharma, M.D., and his co-authors.

JAK inhibitors work by targeting a central pathway in inflammation. The FDA has approved several drugs in this class for AD, including Opzelura (ruxolitinib), a topical treatment, in September 2021 and two oral options in January 2022: Cibinqo (abrocitinib) and Rinvoq (upadacitinib). Analysts predict the market for JAK inhibitors will continue to grow as newer options, including delgocitinib and ivarmacitinib, advance through clinical trials.

The medicines aren’t without potential risks. The FDA has issued warnings about the potential for serious side effects associated with JAK inhibitors for chronic inflammatory conditions, including increased risks of infection and blood clots.

Cost has also been an issue for some patients. According to a study published in July 2024 in the American Journal of Managed Care, the estimated annual cost of JAK inhibitors to treat a different skin condition, alopecia areata, was $50,000 after FDA approval.

Those factors — safety, efficacy, cost and availability — were all frequent discussion points among patients in the online forums monitored by the study authors.

“Providers can use the insights gained from this study to address hesitancy better and guide comprehensive, patient-centered discussions with patients regarding JAK inhibitor use,” wrote Sharma and his colleagues.