JAK inhibitors are oral drugs that can help with chronic inflammatory conditions, including psoriasis.
“These are the new kids on the block, one of the newer classes of medications that are effective in chronic inflammatory conditions, such as eczema and psoriasis. JAK inhibitors work by targeting specific inflammatory signaling pathways within cells that lead to inflammation,” says Massick.
While JAK inhibitors have been shown to be effective, they do carry potential serious risk of internal, or systemic, side effects, including increased risk of infection, bone marrow changes with low white counts, blood clots, heart-related events, and increased risk of cancer, she says. Not every patient will experience these side effects; some risks can depend on an individual’s medical history and risk factors, says Massick.
As a class, JAK inhibitors have a black box warning that includes an increased risk of blood clots. Studies have shown that the risk is higher in people with other risk factors for clotting, and the risk is higher in people who take higher doses.
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“A blood clot, such as a deep venous thrombosis (DVT), can cause swelling or pain where the clot forms, most commonly in the lower legs, developing as localized calf redness, swelling, and pain. If the clot travels to the lungs, this can cause a pulmonary embolism, causing shortness of breath and much more severe complications,” she says. A pulmonary embolism is a medical emergency.
Because of this risk, prescribing JAK inhibitors requires careful consideration to ensure that the severity of psoriasis outweighs the potential risk of these more serious side effects, says Massick.
