EFFICACY AND SAFETY OF ORAL JANUS KINASE INHIBITORS FOR ATOPIC DERMATITIS: A NARRATIVE REVIEW
DOI:
https://doi.org/10.31435/ijitss.1(49).2026.4540Keywords:
Atopic Dermatitis, JAK Inhibitors, Upadacitinib, Abrocitinib, Baricitinib, Eczema, Pruritus, Targeted Therapy, Cytokine, ReviewAbstract
Introduction: Atopic dermatitis (AD) is a common chronic inflammatory skin disease characterized by eczematous lesions and intense pruritus, which severely impacts patients’ quality of life. While recent advances such as biologic therapies (e.g., dupilumab) have improved AD management, many patients still experience inadequate disease control, persistent itch, or treatment side effects. The Janus kinase/ signal transducer and activator of transcription (JAK-STAT) signaling pathway has emerged as a key driver of AD’s inflammatory process, making it a promising therapeutic target for new treatments.
Purpose: The aim of this paper was to evaluate the efficacy and safety of oral JAK inhibitor therapies in moderate-to-severe AD. The review synthesizes clinical trial findings for three agents - upadacitinib, abrocitinib, and baricitinib - with a focus on disease-severity endpoints, itch reduction, speed of therapeutic response, long-term disease control, and adverse-event profiles. It also examines how these therapies address previously unmet needs in AD care, including rapid relief of pruritus and treatment options for patients who do not achieve satisfactory outcomes with existing systemic therapies.
Methodology: A narrative literature review was conducted using Google Scholar and PubMed, focusing on clinical trials, extension studies, and meta-analyses published up to 2025 that examined oral JAK inhibitors for AD. Key sources include Phase III randomized controlled trials (RCTs) and their long-term extensions, head-to-head studies comparing JAK inhibitors with biologic therapy, and relevant guidelines. Data on efficacy endpoints (EASI, vIGA-AD, pruritus scores), onset of action, durability of response, and adverse events were extracted and synthesized to present an integrated overview of each drug’s performance and safety.
Conclusions: Oral JAK inhibitors offer rapid and substantial control of skin lesions and pruritus in moderate-to-severe atopic dermatitis. Their distinct efficacy and safety profiles support personalized systemic therapy. Evidence to date indicates that JAK inhibitors are suitable for long-term management with standard monitoring. Future research should clarify their optimal place in the therapeutic algorithm, including direct comparisons and real-world outcomes.
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Copyright (c) 2026 Piotr Szczepański, Justyna Kącikowska, Oliwia Grzelak, Oliwia Bolek, Magdalena Majkowska, Maria Fengier, Weronika Kuśmierczyk, Krzysztof Rogulski, Katarzyna Sordyl, Jakub Trzaskowski
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