Latest News

Review estimates acne risk with JAK inhibitor therapy


 

TOPLINE:

Use of Janus kinase (JAK) inhibitors is associated with a nearly fourfold increase in risk of acne compared with placebo, according to an analysis of 25 JAK inhibitor studies.

METHODOLOGY:

  • Acne has been reported to be an adverse effect of JAK inhibitors, but not much is known about how common acne is overall and how incidence differs between different JAK inhibitors and the disease being treated.
  • For the systematic review and meta-analysis, researchers identified 25 phase 2 or 3 randomized, controlled trials that reported acne as an adverse event associated with the use of JAK inhibitors.
  • The study population included 10,839 participants (54% male, 46% female).
  • The primary outcome was the incidence of acne following a period of JAK inhibitor use.

TAKEAWAY:

  • Overall, the risk of acne was significantly higher among those treated with JAK inhibitors in comparison with patients given placebo in a pooled analysis (odds ratio [OR], 3.83).
  • The risk of acne was highest with abrocitinib (OR, 13.47), followed by baricitinib (OR, 4.96), upadacitinib (OR, 4.79), deuruxolitinib (OR, 3.30), and deucravacitinib (OR, 2.64). By JAK inhibitor class, results were as follows: JAK1-specific inhibitors (OR, 4.69), combined JAK1 and JAK2 inhibitors (OR, 3.43), and tyrosine kinase 2 inhibitors (OR, 2.64).
  • In a subgroup analysis, risk of acne was higher among patients using JAK inhibitors for dermatologic conditions in comparison with those using JAK inhibitors for nondermatologic conditions (OR, 4.67 vs 1.18).
  • Age and gender had no apparent impact on the effect of JAK inhibitor use on acne risk.

IN PRACTICE:

“The occurrence of acne following treatment with certain classes of JAK inhibitors is of potential concern, as this adverse effect may jeopardize treatment adherence among some patients,” the researchers wrote. More studies are needed “to characterize the underlying mechanism of acne with JAK inhibitor use and to identify best practices for treatment,” they added.

SOURCE:

The lead author was Jeremy Martinez, MPH, of Harvard Medical School, Boston. The study was published online in JAMA Dermatology.

LIMITATIONS:

The review was limited by the variable classification and reporting of acne across studies, the potential exclusion of relevant studies, and the small number of studies for certain drugs.

DISCLOSURES:

The studies were mainly funded by the pharmaceutical industry. Mr. Martinez disclosed no relevant financial relationships. Several coauthors have ties with Dexcel Pharma Technologies, AbbVie, Concert, Pfizer, 3Derm Systems, Incyte, Aclaris, Eli Lilly, Concert, Equillium, ASLAN, ACOM, and Boehringer Ingelheim.

A version of this article appeared on Medscape.com.

Recommended Reading

Spironolactone: an ‘inexpensive, effective’ option for acne in women
MDedge Family Medicine
FDA Advisory panels consider easing isotretinoin requirements
MDedge Family Medicine
FDA panels vote to modify isotretinoin iPLEDGE REMS
MDedge Family Medicine
Frustration over iPLEDGE evident at FDA meeting
MDedge Family Medicine
Could combining topical antioxidants with a nonablative laser prevent acne scars?
MDedge Family Medicine
1,726-nm lasers poised to revolutionize acne treatment, expert predicts
MDedge Family Medicine
Analysis reveals recent acne prescribing trends
MDedge Family Medicine
Once-weekly topical therapy shows promise for moderate to severe acne
MDedge Family Medicine
FDA approves fixed dose combination topical treatment for acne
MDedge Family Medicine
Systematic review spotlights the use of nutraceuticals for acne
MDedge Family Medicine