JAK inhibitor treatment may increase risk for acne

Key takeaways:

• Acne was an adverse event for 6.2% of patients treated with Janus kinase (JAK) inhibitors vs. 1.3% of controls.
• JAK inhibitor-treated patients were 3.83 times more likely to develop acne than controls.

Treatment with Janus kinase inhibitors may be associated with elevated odds of acne, especially among those with dermatologic conditions, according to a study.

“While [Janus kinase (JAK)] inhibitors hold promise as a valuable treatment option for patients with inflammatory conditions, acne has been a commonly reported adverse effect in clinical trials of JAK inhibitors,” Jeremy Martinez, MPH, of Harvard Medical School, and colleagues wrote.

The systematic review included 25 unique phase 2 and phase 3 studies for a total sample size of 10,839 subjects. Participants in these studies were either controlled or treated with any one or combination of JAK inhibitors.

Results showed that acne was an adverse event for 6.2% of JAK-treated patients vs. 1.3% of controls, making JAK-treated patients 3.83 (95% CI, 2.76-5.32) times more likely to develop acne than controls.

JAK inhibitors with the highest odds ratios for acne development were abrocitinib (OR = 13.47; 95% CI, 3.25-55.91), baricitinib (OR = 4.96; 95% CI, 2.52-9.78), upadacitinib (OR = 4.79; 95% CI, 3.61-6.37), deucravacitinib (OR = 2.64; 95% CI, 1.44-4.86) and deuruxolitinib (OR = 3.3; 95% CI, 1.22-8.93).

Subjects receiving JAK1-specific inhibitors (OR = 4.69; 95% CI, 3.56-6.18), combined JAK1 and JAK2 inhibitors (OR = 3.43; 95% CI, 2.14-5.49) or tyrosine kinase 2 inhibitors (OR = 2.64; 95% CI, 1.44-4.86) were also more likely to experience acne than controls.

On the other hand, there were no differences in acne incidence in pan-JAK inhibitors or JAK3-specific inhibitors.

Studies that utilized JAK inhibitors specifically for dermatologic conditions compared with studies that used JAK inhibitors to treat non-dermatologic diseases also had higher estimated odds ratios (OR = 4.67; 95% CI, 3.1-7.05).

“These findings suggest that patients should be properly counseled on the potential adverse effect of acne before beginning treatment with JAK inhibitors,” the authors wrote.