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Related Experiment Video

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Topical Ruxolitinib and Delgocitinib Versus Systemic JAK Inhibitors: A Comparative Safety Review.

Simone Lisa Böll1, Seyed Morteza Seyed Jafari1, Curdin Conrad2

  • 1Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.

International Journal of Molecular Sciences
|November 13, 2025
PubMed
Summary

Topical Janus Kinase Inhibitors (t-JAKi) provide targeted treatment for inflammatory skin conditions with minimal systemic absorption. These t-JAKi demonstrate a favorable safety profile, suggesting they are safer alternatives to systemic JAK inhibitors for many patients.

Keywords:
Janus kinase inhibitorsatopic dermatitischronic inflammatory skin diseasesdelgocitinibruxolitinibsafety profilesystemic therapytopical therapy

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Area of Science:

  • Dermatology
  • Pharmacology
  • Immunology

Background:

  • Janus Kinase Inhibitors (JAKi) are a new drug class for chronic inflammatory skin diseases.
  • Topical JAKi (t-JAKi) offer localized treatment with potentially fewer systemic side effects than systemic JAKi (s-JAKi).

Purpose of the Study:

  • To review the pharmacokinetics and safety of topical ruxolitinib and delgocitinib.
  • To compare the safety and efficacy of t-JAKi with s-JAKi.

Main Methods:

  • Narrative review of pharmacokinetic and safety data for available t-JAKi.
  • Comparative analysis of t-JAKi and s-JAKi clinical trial data.

Main Results:

  • Topical ruxolitinib achieves effective skin concentrations with minimal systemic exposure.
  • Adverse events for t-JAKi were primarily localized, with systemic events similar to placebo.
  • Delgocitinib also showed negligible systemic absorption and a favorable safety profile.

Conclusions:

  • Topical JAKi may be safer alternatives to systemic JAKi for patients with localized inflammatory skin diseases, especially those with comorbidities.
  • Further long-term studies and real-world data are necessary to confirm sustained safety and clinical integration.