Christopher Bunick, MD, PhD: Facts About Systemic Therapies’ Safety, Mechanism of Action

At the 44th Annual Fall Clinical Dermatology Conference in Las Vegas, a presentation was given by 4 speakers titled ‘Systemic Therapies for Inflammatory Skin Diseases: How To Choose Between Monoclonal Antibodies, JAK Inhibitors and Other Therapies.’

One of the presenters was Christopher Bunick, MD, PhD, Yale School of Medicine associate professor, who was asked by the HCPLive editorial team to speak about the mechanism of action (MOA) of systemic therapies as well as these drugs’ safety.

“The very first thing I focused on was actually systemic corticosteroids, and we know at least for atopic dermatitis that the new 2024 guidelines that were published by the American Academy of Dermatology conditionally recommend against the use of systemic steroids for treating atopic dermatitis,” Bunick explained. “Here at Fall Clinical, I'm an author on a presentation actually looking at systemic corticosteroid use in atopic dermatitis patients.”

As highlighted in Bunick’s team’s work regarding topical corticosteroids, he noted that about 20% of atopic dermatitis patients still receive some form of systemic corticosteroids. He added that they have been overprescribed, especially considering their safety rates are worse than those of Janus Kinase (JAK) inhibitors.

“Then I emphasized the long term safety of JAK inhibitors,” Bunick said. “Obviously, JAK inhibitors have been a big topic for a couple years in dermatology. We see them, not only in atopic dermatitis, but also psoriasis, and alopecia areata. The long term safety of JAK inhibitors are impressive…as we gain more and more data about the long term safety of JAK inhibitors, they're proving to be safer than we could have ever hoped. And so I touched on the fact that both uopadacitinib and abrocitinib in atopic dermatitis.”

Bunick noted their long term safety data which he mentioned shows lower rates of major adverse cardiovascular events (MACE) as well as venous thromboembolism (VTE) events compared to the background atopic dermatitis population not on JAK inhibitor therapy.

“This should be really reassuring to providers that they can safely incorporate and use JAK inhibitors in treatment of their atopic dermatitis patients,” he said. “And the way I kind of summarize that is when you think about JAK inhibitors, your first thought should be their powerful way that they cool down inflammation, not concerns over safety.”

For additional information on systemic therapies and the facts discussed in this interview, view the full video posted above. To learn more about related topics, view our latest conference coverage here.

The quotes contained in this interview summary were edited for clarity.