Christopher Bunick, MD, PhD: New Data on JAK Inhibitors for Atopic Dermatitis

During this HCPLive interview segment, Christopher Bunick, MD, PhD, compared upadacitinib’s safety data with traditional systemic immunotherapies for moderate-to-severe atopic dermatitis (AD) at the Revolutionizing Atopic Dermatitis (RAD) 2023 Annual Meeting in Washington, DC.

Bunick works as Associate Professor of Dermatology at the Yale School of Medicine, and his research has involved the 3-dimensional structures of skin-related proteins using x-ray crystallography and cryo-electron microscopy.

“What was really important was that the safety rates for some of the serious adverse events that we're monitoring when patients are on upadacitinib were actually lower than the safety event rates for some of the traditional systemic immunotherapies, like methotrexate, cyclosporine, or systemic corticosteroids, that we all used a decade ago,” he explained.

He added that as more data comes out on JAK inhibitors, it is more apparent that JAK inhibitors should be placed ahead of systemic immunosuppressants as they have better safety and efficacy data.

“And this is really reassuring to the entire field of dermatology, and to the patients who really need these medicines to get better, and they need these medicines to maintain that therapy of response,” Bunick stated. “But they need that reassurance that they can continue on the medicine and maintain their response to therapy. I think atopic dermatitis is going through, appropriately, a revolution. Hence, the RAD conference here.”

Bunick explained that there has been a big emphasis over the past 10 years on moving towards precision medicine, specifically using molecular targeting of therapies to precise pathways that are drivers of disease pathogenesis. Psoriasis was a major beneficiary of this trend for a while, he added.

“But over the last approximately 6 to 7 years, atopic dermatitis is catching up very fast,” he said. “We have biologic therapies that are very targeted to interleukin 4 receptor alpha. We have biologics that target interleukin-13. We have biologics in development that target a different epitope of interleukin-4 receptor alpha…And we have all of the small molecule inhibitors, now the JAK inhibitors, including your upadacitinib and abrocitinib, and others in development.”

Bunick noted that new cutting edge therapies are now achieving Eczema Area and Severity Index (EASI)-90, and its ratings on the Numeric Rating Scale (NRS) scale down to 0 or 1.

He noted that the dermatology world is seeing a movement of that bar in AD, as with psoriasis, where therapies are getting better and better.

To find out more on this late-breaking data, view the full interview segment above.