The most common conditions or concerns patients reported having that may influence their selection of a JAK inhibitor included an increased risk of MACE and an age above 65 years.
More than half of adult patients with moderate to severe atopic dermatitis (AD) reported having a condition or potential consideration that may impact or influence their selection of a JAK inhibitor for treatment, according to a poster presented at the 2023 Society of Dermatology Physician Assistants Fall Conference in Nashville, TN.1
Investigators Han et al sought to estimate the proportion of patients with more severe AD who may have conditions or considerations impacting their use and selection of a JAK inhibitor. The retrospective study conducted between January 2015 and September 2020 used the OptumInsight Clinformatics Data Mart Database to identify adult patients with moderate to severe AD who fit additional study criteria, including disease severity and previous treatment with phototherapy, systemic immunomodulatory medication, or dupilumab (Dupixent).
Investigators identified 143,925 adult patients with moderate to severe AD. Approximately 66.5% of patients identified had an additional comorbidity, and on average, patients had a 0.8 ± 1.5 Charlson Comorbidity Index score. The majority of patients involved in the study (95.1%) had a history of prior use of a systemic corticosteroid linked to their AD.
In total, 63.2% of patients were identified with a consideration potentially influencing JAK inhibitor use, including relative contraindications, warnings, precautions, DDIs, or age above 65 years.
Of these, 46.2% of exhibited considerations due to boxed warnings, such as an increased risk of MACE; high risk factors such as diabetes, smoking, or heart failure; low or moderate risk factors such as hypertension or obesity; increased risk of thrombosis; or any malignancy.
Approximately 42.4% of patients had considerations due to precautions associated with hyperlipidemia, hypolipidemia, an increased risk of gastrointestinal perforations, or thrombocytopenia.
A significant portion of patients (38.7%) were identified as being above the age of 65, another potential consideration for JAK inhibitor use.
A smaller proportion of patients were identified with relative contraindications (16.2%) or concerns of drug-drug interactions (1.8%).
“Over half of adults with moderate-to-severe AD had conditions potentially influencing the selection of JAK inhibitors, most commonly due to increased risk of MACE, and age ≥ 65,” wrote study authors Han et al. “To further confirm results and quantify specific attributable risks, database studies with longer time periods where diagnoses can be confirmed by physicians or additional prospective studies may be helpful.”