1. Will I need to be on a JAK inhibitor forever?
3. How long will it take before I see improvement with a JAK inhibitor?
4. Could a JAK inhibitor stop working over time?
5. JAK inhibitors are new. Are they safe?
2. How do I decide if a JAK inhibitor is right for me?
9. Will I have to take these medications forever?
8. Will I be able to afford this medication?
7. JAK inhibitors are still pretty new – are you sure they’re safe?
6. I read that JAK inhibitors increase the risk of blood clots. Should I be worried?
5. Can taking a JAK inhibitor cause cancer?
4. Why do I need to get certain vaccinations first?
3. Will taking a JAK inhibitor shut down my immune system?
2. If one JAK inhibitor doesn’t help me, does that mean none of them will?
1. Which JAK inhibitor is most likely to help me?
FAQs About Treating Atopic Dermatitis With JAK Inhibitors, Answered
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6. I may have to take a JAK inhibitor. Did I do anything wrong?
7. What if I want to get pregnant? Can I take a JAK inhibitor?
"That’s definitely the most common question I get asked, and one that I think is often frustrating for people,” Garshick says. Rather than focusing on forever, think about taking things one day at a time. JAK inhibitors are intended for long-term use, to get at the root cause of eczema and keep symptoms from flaring, but unlike biologics, JAK inhibitors come in pill form, so there’s no need to visit your dermatologist for injections. And they’ve been shown to be safe for long-term use in other conditions, such as RA, with minimal side effects.
Rare is the child who will willingly roll up their sleeve for an injection. And chances are, you aren’t looking forward to the jab, either. While an injection takes some getting used to, many parents are reassured by the fact that the medication is safe, seems to have few side effects, and is effective, says Vij. Another bonus: The biologic doesn’t require frequent lab monitoring and blood draws — something that also requires needles — not to mention extra appointments, which can be time consuming, says Kwatra. Your doctor will give you instructions on how to administer the injection, find the proper dosage, and store the medication.
1. What if my child is afraid of needles?
The treatment selection process is highly individualized. Your dermatologist will take a history of your skin symptoms and ask how they’re impacting your quality of life. If your skin is cracked and oozing, or if you feel like you can’t go about your daily activities, your dermatologist will factor this in.
You aren’t the only one who balks at the idea of giving yourself an injection. Many people are so satisfied with the results, though, that the benefits outweigh the negatives, says Kwatra. Your doctor will also give you instructions on how to use the syringe or pen, as well as how to store the medication. Another benefit: Unlike other meds for atopic dermatitis, dupilumab doesn’t require blood work, which cuts down on injections aside from the biologic, he says.
1. What if I’m afraid of needles?
This varies from person to person. Although some people see results in as little as three days, it may take up to a month before you notice a significant improvement, Garshick says.
Yes, it’s possible for any treatment to stop working over time — but that doesn’t necessarily mean that yours will. “Certainly, there’s always the possibility, and if we needed to, the nice thing about having options is that we can always rely on something else,” says Garshick. So far, newer options such as JAK inhibitors have provided sustainable results over time, she adds.
There can be some side effects from using biologics for atopic dermatitis, but in general, there aren’t very many, says Vij. You may experience some pain or swelling around the injection site, for example. You shouldn’t use dupilumab or tralokinumab-Idrm if you are allergic to the medication or any of the ingredients in the injection. (You can ask your pharmacist for a list of what’s in the medications).
3. Are there side effects?
Although JAK inhibitors are new in the treatment of eczema, the FDA approved them for RA in 2012. In people with RA, they’re generally safe, though they may increase the risk of infection in those taking them, according to a review published in the December 2021 issue of the Expert Review of Clinical Immunology. Similarly, in clinical trials, they were found to be effective and safe for people with moderate to severe eczema. Be sure to discuss potential risks and side effects with your doctor.
List prices for biologics can run into the thousands of dollars, but many private and commercial health insurance plans cover this cost, says Kwatra. (Depending on what type of plan you have and whether you’ve met your deductible, you may have to pay a portion of the cost.) For example, many people with Medicare may pay less than $100 a month for one of these medications, and people with Medicaid may pay less than $10 a month. Even if you don’t have insurance, you may be eligible for a patient assistance program that can help you cover the costs.
4. How much does it cost?
No — though you aren’t alone in wondering this. This is a common question among people with eczema, according to Garshick. There are things you can do to manage your condition, though. In addition to taking your medication consistently and as prescribed, be sure to follow lifestyle habits that can help your skin. This includes showering in warm water rather than hot, moisturizing your skin regularly, and avoiding abrasive cosmetics, soaps, and detergents that can irritate your skin.
It’s not known whether JAK inhibitors are safe during pregnancy. “With a lot of these newer medications, we don’t necessarily have all the studies in pregnancy” to know whether there are potential problems, says Garshick. (Some older eczema medications, including methotrexate, shouldn’t be used during pregnancy.) If you want to get pregnant and are worried how medications will affect the health of you or your baby, know that there are other options that have been shown to be safe during pregnancy, such as light therapy.
