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. 2024 Apr;14(4):919-932.
doi: 10.1007/s13555-024-01135-x. Epub 2024 Mar 21.

Management of Patients Affected by Moderate-to-Severe Atopic Dermatitis with JAK Inhibitors in Real-World Clinical Practice: An Italian Delphi Consensus

Luigi Gargiulo  1   2 , Luciano Ibba  3   4 , Piergiorgio Malagoli  5 , Anna G Burroni  6 , Andrea Chiricozzi  7   8 , Paolo Dapavo  9 , Silvia M Ferrucci  10 , Massimo Gola  11 , Maddalena Napolitano  12 , Michela Ortoncelli  9 , Maria T Rossi  13 , Claudio Sciarrone  14 , Antonio Costanzo  1   2 , Alessandra Narcisi  1
Affiliations

Management of Patients Affected by Moderate-to-Severe Atopic Dermatitis with JAK Inhibitors in Real-World Clinical Practice: An Italian Delphi Consensus

Luigi Gargiulo et al. Dermatol Ther (Heidelb). 2024 Apr.

Abstract

Introduction: Several systemic therapies have been approved for the treatment of severe AD. In particular, Janus kinase inhibitors (JAKi), including abrocitinib, baricitinib, and upadacitinib, recently received approval for the treatment of patients with severe AD after being evaluated in several clinical trials. However, a few concerns have been raised regarding their long-term safety and the management of these drugs in real-world clinical practice. In this article we described the results of a Delphi consensus aimed at describing the knowledge on JAKi and focusing, in particular, on providing clinical recommendations for dermatologists in daily practice regarding the use of these drugs.

Methods: Twelve Italian dermatologists reviewed the most recent literature regarding the efficacy and safety profiles of JAKi and proposed 24 statements.

Results: Agreement was reached for statements focusing on three main topics: (1) place in therapy of JAKi in patients with moderate-to-severe AD; (2) effectiveness and safety of JAK inhibitors in different phenotypes; (3) different approaches to the management of patients treated with JAKi in clinical practice. The panel proposed several recommendations regarding all the statements.

Conclusion: Given the wide use of JAKi in clinical practice, it is crucial to establish a specific follow-up for each patient's phenotype in order to achieve the best possible clinical outcome and minimize potential adverse events.

Keywords: Abrocitinib; Baricitinib; Consensus; Delphi; JAK inhibitors; Real life; Upadacitinib.

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Conflict of interest statement

Luigi Gargiulo has been a consultant for Almirall. Luciano Ibba has been a consultant for Almirall. Piergiorgio Malagoli has been a speaker for AbbVie, Lilly, Novartis, Janssen-Cilag, Celgene, Leopharma, and Almirall. Andrea Chiricozzi has served as advisory board member and consultant and has received fees and speaker’s honoraria or has participated in clinical trials for AbbVie, Almirall, Bristol Myers Squibb, Leo Pharma, Lilly, Janssen, Novartis, Pfzer and Sanof Genzyme. Paolo Dapavo has been a speaker for Novartis, Abbvie, Sanofi, UCB, Janssen, Lilly, and LeoPharma. Silvia M. Ferrucci has been principal investigator in clinical trials for ABBVIE, Almirall, Galderma, Leo Pharma, Sanofi, Amgen, Novartis, Bayer and received honoraria for lectures for Novartis and Menarini. Maddalena Napolitano acted as speaker, consultant and/or advisory board member for Abbvie, Eli Lilly, Leo Pharma, Novartis, and Sanofi. Michela Ortoncelli has served as a consultant and/or speaker for AbbVie, LEO Pharma, Novartis and Sanofi. Maria T. Rossi has received personal fee for advisory board meeting from Sanofi, Abbvie, Novartis, and Cantabria. Antonio Costanzo has served as an advisory board member, consultant and has received fees and speaker’s honoraria or has participated in clinical trials for Abbvie, Almirall, Biogen, LEO Pharma, Lilly, Janssen, Novartis, Pfizer, Sanofi Genzyme, and UCB-Pharma. Alessandra Narcisi has served on advisory boards, received honoraria for lectures and research grants from Almirall, Abbvie, Leo Pharma, Celgene, Eli Lilly, Janssen, Novartis, Sanofi-Genzyme, Amgen and Boehringer Ingelheim. Anna G. Burroni, Massimo Gola and Claudio Sciarrone have nothing to declare.

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