2) This program is supported by educational grants from Pfizer & Incyte. Faculty disclosures https://t.co/UB9pTq2EQc. This program is intended for #healthcare providers. Please FOLLOW US and let's build a new #CME/CE network: #physicians #physicianassociates #nurses #pharmacists
— @derm_ce (@derm_ce) May 9, 2022
4a) We've understood the #pathophysiology for a long time. We know that atopic dermatitis (#AD) is the most common & relapsing allergic disease of the skin. AD is characterized by a predominant expression of type 2 cytokines associated with . . .
— @derm_ce (@derm_ce) May 9, 2022
5) Additionally, it is widely appreciated that innate cells such as #ILC2s and #basophils are also major sources of such cytokines and implicated in #AD (🔓https://t.co/D4U3Hyt5Qb)
— @derm_ce (@derm_ce) May 9, 2022
7) Want to read up on this? ✔️out my articles at 🔓https://t.co/qWtV0Iprds and 🔓https://t.co/9CTP4Wp70t. pic.twitter.com/jd2iadczSx
— @derm_ce (@derm_ce) May 9, 2022
9) These are JAK1, JAK2, JAK3, and TYK2 (I know, why not just JAK4?). pic.twitter.com/Yai75OkFQ2
— @derm_ce (@derm_ce) May 9, 2022
11) If you inhibit JAKs on white blood cells, they will suppress cell activation & production of cytokines. If you inhibit JAK on skin cells, they will reverse pathological proliferation & barrier damage. See 🔓https://t.co/rqqz0HzX71 for summary of JAK signaling in the skin pic.twitter.com/CWEvk3Yz8N
— @derm_ce (@derm_ce) May 9, 2022
13) Thus, JAK inhibitors draw a lot of their benefits from their ability to suppress inflammation produced by white blood cells and exerted on the tissue (skin).
— @derm_ce (@derm_ce) May 9, 2022
15) Therefore, a unique property of JAK inhibitors is that they are both anti-inflammatory and anti-itch by directly acting in the nervous system.
— @derm_ce (@derm_ce) May 9, 2022
17) So how 'bout a quick knowledge ✔️? Which of the #JAKi's is most important to block in order to ⬇️itch in #AD?
— @derm_ce (@derm_ce) May 9, 2022
19) Welcome back! You are tuned in to our #accredited #tweetorial on @derm_ce, your ONLY source for CE/#CME in #dermatology by Twitter! I am @itchdoctor. Hello, @andrewlji @MassimoGadina @DrJTakeshita @bwhdermatology @ealtmanmd @CrystalAguhMD @paller_lab @yalederm
— @derm_ce (@derm_ce) May 10, 2022
21) So the take home point in terms of efficacy is that JAKi's are highly effective in terms of overall disease improvement, & their anti-itch effects are a unique attribute. For a good overview of itch biology as it pertains to atopic dermatitis see 🔓https://t.co/SRGdEBMpFd pic.twitter.com/mrfZtc9C3B
— @derm_ce (@derm_ce) May 10, 2022
23) . . . meaning it targets all the JAKs more broadly than these recently approved JAKi's. Overall, in long-term data in #RA, the incidence of major adverse cardiovascular events (#MACE) and #cancer & certain opportunistic #infections were . . .
— @derm_ce (@derm_ce) May 10, 2022
25) Given that newly approved #JAKi's have not been used for very long, whether they will have similar long-term concerns as with tofacitinib remains to be determined. The new JAK inhibitors as a group have demonstrated hematologic effects including . . .
— @derm_ce (@derm_ce) May 10, 2022
27) Long term follow-up with the new JAKi's will be imp't as they are more selective (#abrocitinib & upadacitinib) than tofacitinib, or are topical in formulation (#ruxolitinib), & are used in a generally healthier population of pts w/atopic dermatitis (vs. rheumatoid arthritis)
— @derm_ce (@derm_ce) May 10, 2022
29) Some patients may simply feel that the overall combination of response in terms or rash and itch may just be better with a specific drug like a JAK inhibitor. pic.twitter.com/14UELZgehm
— @derm_ce (@derm_ce) May 10, 2022
31) So we just had the annual meeting of the American Academy of Dermatology. Anything new there on #JAKi and #AD? Well, lots of talk about @US_FDA having just approved both (orals) #abrocitinib and #upadacitinib to join topical #ruxolitinib for #atopic #dermatitis.
— @derm_ce (@derm_ce) May 10, 2022
33) The most frequently reported treatment-emergent adverse events were upper respiratory tract infection and #hypertension. They also reported that the mean percentage of affected body surface area ⬇️during the long-term safety period.
— @derm_ce (@derm_ce) May 10, 2022
35) So the bottom here line is that the approval of JAK inhibitors for atopic dermatitis is a big win for patients and that we need to be very thoughtful about using them in the best way possible and monitoring for safety along the way!
— @derm_ce (@derm_ce) May 10, 2022
36) Thanks for joining us! Now go to https://t.co/AdNUtE2aMz and claim your 🆓CE/#CME! And follow us here on @derm_ce for more educational programs by expert authors!
Tip o' the hat to @Aller_MD @DrCorinneHappel @DrRamonGrimalt @VenterCarina @MauiDerm @IgECPD @khsu_blatman— @derm_ce (@derm_ce) May 10, 2022
