AUTHOR=Le Michelle , Berman-Rosa Melissa , Ghazawi Feras M. , Bourcier Marc , Fiorillo Loretta , Gooderham Melinda , Guenther Lyn , Hanna Sameh , Hong H. Chih-Ho , Landells Ian , Lansang Perla , Marcoux Danielle , Wiseman Marni C. , Yeung Jensen , Lynde Charles , Litvinov Ivan V. 

TITLE=Systematic Review on the Efficacy and Safety of Oral Janus Kinase Inhibitors for the Treatment of Atopic Dermatitis

JOURNAL=Frontiers in Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.682547

DOI=10.3389/fmed.2021.682547

ISSN=2296-858X

ABSTRACT=Background: Atopic dermatitis is a chronic, relapsing and remitting disease that can be difficult to treat despite a recently approved biologic therapy targeting IL-4/IL-13 receptor.  Oral janus kinase inhibitors (JAKi) represent a novel therapeutic class of targeted therapy to treat moderate-to-severe atopic dermatitis (AD). 
Objective: To review the efficacy, safety, and pharmacokinetic characteristics of oral JAKi in the treatment of AD.

Methods: A PRISMA systematic review was conducted using MEDLINE, EMBASE (Ovid), and PubMed databases for studies assessing the efficacy, safety, and/or pharmacokinetics of oral forms of JAKi in the treatment of AD in pediatric or adult populations from inception to December 2020.
Results: 367 papers were reviewed. Of 21 articles that underwent full text screening, 8 met our inclusion criteria for final qualitative review. Three studies examined abrocitinib; three studies examined baricitinib; one examined gusacitinib (ASN002), and another upadacitinib. Significant clinical efficacy and a reassuring safety profile was reported for all JAKi agents reviewed.  Rapid symptom control was reported for abrocitinib and baricitinib. 

Limitations: Given the relatively limited evidence for each JAKi and the differences in patient eligibility criteria between studies, the data was not deemed suitable for a meta-analysis at this time.

Conclusion: Given their ability to achieve rapid symptom control with a reassuring safety profile, we recommend considering the use of JAKi as a reliable systemic treatment option for adult patients with moderate-to-severe AD, who are unresponsive to topical or skin directed treatments.