How to Explain JAK Inhibitor Safety to Patients

Lisa Swanson, MD, a dermatologist and pediatric dermatologist at Ada West Dermatology in Boise, Idaho, affiliated with St. Louis Children's Hospital, shared practical strategies for counseling patients about oral JAK inhibitor safety during an interview with Dermatology Times at the Elevate Derm Summer conference in San Diego. She also discussed the questions patients ask most often, her early experience prescribing the drug class, and where she believes oral JAK inhibitors could expand next.

Communicating JAK Inhibitor Safety to Patients

Swanson said one of the primary goals of her Elevate presentation was helping clinicians communicate JAK inhibitor safety clearly and efficiently. She explained that developing a consistent explanation allows clinicians to address safety concerns thoroughly without overwhelming patients or extending already busy clinic visits. After refining her approach through repeated conversations in practice, she now relies on the same explanation several times each day.

The biggest pearl I hope attendees remember is how to break down the safety of JAK inhibitors to discuss it with your patients and their families, said Swanson.

She added that the approach has become second nature in clinic. “I say it every single day, three or four or five times a day” Swanson added.

Patient Questions Vary by Disease State

Swanson said patient questions often reflect the goals of treatment for each disease state. Rather than asking the same questions across conditions, patients tend to focus on how therapy will affect the outcomes that matter most to them.

Patients with Atopic Dermatitis most commonly ask how long they will need to remain on a JAK inhibitor, whereas patients with alopecia areata are typically more interested in how quickly they can expect hair regrowth.

Early Experience With Off-Label JAK Inhibitor Use

Swanson said her confidence with the drug class developed years before current approvals, when published case reports began describing off-label tofacitinib use for severe alopecia areata. Wanting to help patients with limited treatment options, she began prescribing the therapy off-label and gained firsthand clinical experience as evidence for JAK inhibitors continued to emerge.

Future Opportunities for Oral JAK Inhibitors

Swanson identified 3 areas where she hopes oral JAK inhibitors will continue to expand.

First, she would like to see younger pediatric indications, particularly for children younger than 12 years with atopic dermatitis and alopecia areata. She also pointed to vitiligo, noting that although topical ruxolitinib has expanded treatment options, many patients have more than 10% body surface area involvement and could benefit from an oral therapy.

“A lot of patients have more than 10% BSA of their vitiligo, and I want to treat them and help them,” Swanson said.

Swanson also identified hidradenitis suppurativa as another area of opportunity. Although several new therapies have recently become available, she said clinicians are still searching for treatments that more consistently improve outcomes for patients.

I think oral JAK inhibitors will be the missing piece, Lisa Swanson, MD

Together, Swanson said these areas represent opportunities to expand effective treatment options for patient populations that continue to have significant unmet needs.

References:

1. Swanson L. How to discuss JAK inhibitor safety with patients and families. Presented at: Elevate Derm Summer; July 29-31, 2026; San Diego, CA.
2. Swanson L. Interview with Dermatology Times. Recorded July 30, 2026.