JAK Inhibitors Linked to Lower Adjunctive Therapy Use Than Dupilumab in AD
Key Takeaways
JAK inhibitor–treated AD patients used fewer adjunctive therapies than patients on dupilumab at 6 to 12 months post-treatment.
The study showed reductions in systemic corticosteroid and high-potency topical agent use.
Authors said the results support a potential role for JAK inhibitors in AD treatment regimens that exclude steroids.
Patients with atopic dermatitis (AD) treated with oral Janus kinase (JAK) inhibitors used fewer adjunctive therapies over the long term compared to those receiving dupilumab, according to a retrospective study published ahead of print in The Journal of Allergy and Clinical Immunology: In Practice.
The analysis included EHR-derived data on 1,241 biologic-naïve patients (mean age, 39 years) assigned to JAK inhibitors and 1,241 matched dupilumab-treated patients. Cohorts were well-balanced after propensity score matching on demographics and clinical variables. The researchers employed propensity score matching to balance the cohorts for
The study tracked use of systemic corticosteroids, phototherapy, topical corticosteroids, topical calcineurin inhibitors, and topical antibiotics for up to one year following treatment initiation. The primary analysis excluded the first 30 days to minimize the impact of early treatment adjustments.
Patients in the JAK cohort had lower risk ratios vs. dupilumab for systemic corticosteroids (RR = 0.90; 95% CI 0.81 to 0.99), topical corticosteroids overall (RR = 0.88; 95% CI 0.81 to 0.95), high-potency topical corticosteroids (RR = 0.86; 95% CI 0.78 to 0.95), and topical calcineurin inhibitors (RR = 0.73; 95% CI 0.63 to 0.86). Differences were noted and sustained during the 6-to-12-month follow-up period. Researchers reported no significant differences in phototherapy use, low-to-medium potency topical corticosteroids, or topical antibiotics.
“Monotherapy with concomitant reduction or discontinuation of adjunct therapies may help simplify the medication list, increase adherence, minimize adverse effects associated with chronic corticosteroid and tacrolimus use, and reduce excess costs,” the authors wrote. “More clinical data are warranted to understand whether the step-down strategy would compromise long-term efficacy and whether JAK inhibitors exhibit a steroid-sparing effect in AD."
Source: Tsai S, et al. Journal of Allergy and Clinical Immunology: In Practice. 2025. doi:10.1016/j.jaip.2025.08.007