JAK inhibitor use in skin conditions associated with elevated odds of the appearance of acne: JAMA

JAK inhibitors have shown promise as a treatment option for inflammatory conditions, but acne is a commonly reported side effect. However, there is limited information on the overall incidence of acne and how it varies between drug classes and underlying conditions. This study analyzed the risk of acne associated with JAK inhibitors across phase 2 and 3 placebo-controlled randomized clinical trials.

To assess the incidence of acne in phase 2 and 3 placebo-controlled randomized clinical trials (RCTs) of JAK inhibitors, the present study team searched the Ovid MEDLINE and PubMed databases for studies published in English from January 31, 2023. Studies included reported adverse events of acne. Two reviewers independently reviewed and extracted information from all included studies. The primary outcome of interest was the incidence of acne following JAK inhibitor use. We conducted a meta-analysis using random-effects models to pool the data from all included studies.

Key findings of this study are:

• Twenty-five unique studies included 54% male and 46 % female participants.
• The pooled odds ratio (OR) was calculated to be 3.83, with increased ORs for abrocitinib, baricitinib, upadacitinib, deucravacitinib and deuruxolitinib.
• Estimated ORs were higher across studies investigating the use of JAK inhibitors for treating dermatologic than nondermatologic conditions, as well as for JAK1-specific inhibitors, combined JAK1 and JAK2 inhibitors and tyrosine kinase two inhibitors.

They said in this study, we recorded the use of JAK inhibitors with elevated odds of acne. Patients should be appropriately counselled on the potential adverse effects of these medications before treatment initiation.

Further studies are needed to characterize the underlying mechanism of acne with JAK inhibitor use and identify best treatment practices.

Janus kinase (JAK) inhibitors are increasingly used for many dermatologic conditions. Acne vulgaris negatively impacts self-esteem, mental well-being, and social functioning. Furthermore, the potential for developing acne following treatment with JAK inhibitors is a concern, as this adverse effect may cause some patients to hesitate in adhering to their treatment plan.

Reference:

Martinez J, Manjaly C, Manjaly P, et al. Janus Kinase Inhibitors and Adverse Events of Acne: A Systematic Review and Meta-Analysis. JAMA Dermatol. Published online October 18, 2023. doi:10.1001/jamadermatol.2023.3830