Neal Bhatia, MD: What You Should Know About JAK and TYK2 Inhibitors

Neal Bhatia, MD, spoke with HCPLive about the biggest highlights from his presentation on TYK and JAK inhibitors for dermatologic conditions, a talk given at the Clinical Dermatology 2023 Conference for PAs & NPs.

Bhatia is known for his work as a leading dermatologist in Southern California, working as Director of Clinical Dermatology at Therapeutics Clinical Research and chief medical editor for Practical Dermatology.

“My background allows itself to be able to translate some of the mechanisms of action so that a lot of the PAs and NPS can look at this in terms of relative immunosuppression and compare this class of drugs to what we used to use which would suppress the immune system or what was more steroid driven,” he began. “And to get through some of the black box warnings and some of the negative history of treating patients with more severe conditions.”

Bhatia explained that atopic dermatitis, psoriasis, alopecia areata, and vitiligo have been dermatologic conditions that have needed a lot of dedicated treatments.

“The safety profiles of (TYK and JAK inhibitors) have really allowed them to see exactly that,” he said. “These are treatments that can be not only very safe, but also easily monitored as well as followed for years at a time.”

Bhatia discussed some of the areas in dermatology that, he feels, are in need of further research where therapies are concerned.

“It's been nice to see alopecia areata finally get a treatment, which is baricitinib,” he explained. “I think this is one of those conditions where patients are going to come to us. They're the ones on the chat rooms, banging down the door, saying ‘I want this’ because they see the results.”

Bhatia went on to describe some other points he covers in his conference presentation.

“For the atopic patients and psoriasis patients, it's a lot of indecision and a lot of concern about the consequence rather than getting better within 3 days, in terms of the itching and seeing the long term safety with psoriasis,” he said. “So, my lecture is going to point out…there may be black box warnings from what was but look at the adverse event profile and how safe these drugs were in the atopic dermatitis trials and the psoriasis trials.”

While discussing the specific TYK and JAK inhibitors he covered in his talk, Bhatia noted that abrocitinib and upadacitinib both had strong safety profiles and good dose ranging studies, as well as good comparisons to dupilumab in different trials.

“Now they're both available for 12 years and up, which is great,” he noted. “We may see some more pediatric doses even further down the road. But again, those 2 set the bar for treating atopic dermatitis, which is great for us. Whereas baricitinib is approved in Europe, but for us is available for alopecia areata, which is fantastic.”

Bhatia further described some of the latest developments in dermatologic therapies that he covered in his talk.

“I think when we see ritlecitinib come out for vitiligo a few years from now, I think that'll be good because we need a good oral,” he said. “...And then there's some others down the road.”

For more information about both types of drugs, view the full interview segment above.

The quotes contained in this description are edited for clarity.