JAK Inhibitor Safety in Atopic Dermatitis: Long-Term Epidemiology Data

Christopher Bunick, MD, PhD, associate professor of dermatology at the Yale School of Medicine and editor in chief of Dermatology Times, presented in a JAK inhibitor symposium at Fall Clinical 2026 focused on the safety narrative for JAK inhibitors in atopic dermatitis. Bunick and his fellow presenters covered the limitations of the ORAL Surveillance study and the latest epidemiology data.

Epidemiology Data for Upadacitinib and Abrocitinib

The presenters reviewed rates of MACE, VTE, and malignancy with upadacitinib (Rinvoq; AbbVie) and abrocitinib (Cibinqo; Pfizer) in atopic dermatitis. They compared those adverse event rates with other medicines, including the IL-13 biologic tralokinumab (Adbry; LEO Pharma). For the first time, they also presented a comparison with oral apremilast (Otezla; Amgen), an agent dermatologists consider very safe.

Bunick said the long-term atopic dermatitis data now span around 7 years for upadacitinib and abrocitinib.

“Seven-year safety rates of those drugs in atopic dermatitis are no higher than the rates of apremilast in psoriasis or psoriatic arthritis,” Bunick said.

“Ultimately, all the data is reassuring,” he added.

Biomarker Data and Cardiovascular Risk

The symposium also covered new biomarker data on JAK inhibitors. As Bunick described, these agents lower high-sensitivity CRP and modulate or downregulate some cardiovascular risk factors. One study suggested upadacitinib could improve myocardial function, a finding Bunick described as “hypothesis-generating,” with more research needed.

Real-World Cases With Comorbidities

The presenters shared cases from their own practices in which JAK inhibitors were used for atopic dermatitis. The patients had different comorbidities, including cancer, a history of clotting, and cardiovascular disease.

“The goal was to not only present the data; we also presented numerous cases of patients from our real-world practices,” Bunick said.

Safety Data and Clinical Responsibility

The goal of the symposium was to reassure attendees as safety data continue to look good for the concerns discussed. Bunick added a caution for clinicians. Reassuring data “doesn’t mean you can relax as a physician and not do your job,” he said.

Oral JAK inhibitors are changing how dermatologists treat atopic dermatitis, particularly in patients on biologics without adequate responses, Bunick said. Use is also growing across alopecia areata, with vitiligo and hidradenitis suppurativa to follow. Continued safety investigation is important to complement the high efficacy bar JAK inhibitors are setting in numerous diseases.

For more coverage from Fall Clinical, click here