Treating Dermatology Patients with Off-Label JAK Inhibitors, With Gabriela Maloney, DO

Since the US Food and Drug Administration (FDA) approved of ruxolitinib cream in 2021, making the topical drug the first Janus kinase (JAK) inhibitor approved in dermatology, JAK inhibitors have seen an explosion in use within the field.1

At the 2025 Society of Dermatology Physician Associates (SDPA) Fall Conference in San Antonio, Texas, Gabriela Maloney, DO, a board-certified dermatologist at Forefront Dermatology, spoke with HCPLive about a session given at the conference titled ‘Off-Label Usage of JAK Inhibitors.’2

“We're often giving [patients] immunosuppressants that require a lot of lab monitoring, a lot of drug interactions, a lot of potential side effects, and they're making people feel slightly better, but not completely clear,” Maloney explained. “And we know that the inflammatory pathway of those conditions involves the JAK-STAT pathway, which is really awesome, because we have great drugs that we can now use. Not only are we able to achieve clearance in levels that we were not able to do before, but we're also able to do it safely.”

Several JAK inhibitors, such as upadacitinib, baricitinib, abrocitinib, and deucravacitinib, have gained FDA approvals in the US in recent years. Maloney noted several key points about such drugs during her talk at SDPA, including providing an overview of the mechanism of action of JAK inhibitors to attendees and discussing ways to implement JAK inhibitors in various inflammatory conditions.

“By inhibiting JAKs, we're really kind of toning down the volume of inflammation, but in a very targeted way,” Maloney highlighted. “We're not wiping out the immune system. We're not depleting their white cells, T cells, or B cells. We really are just dialing down that volume knob a little bit lower. A lot of inflammatory conditions have the JAK-STAT pathway involved in them. So by controlling that, we're able to kind of pinpoint the way that we're addressing the disease.”

I mean, there are a lot of drugs that are on phase 3 and 2 trials for vitiligo and for hidradenitis suppurativa, two chronic conditions that we really don't have great medications for,” Maloney said. “Also, bullous diseases like bullous pemphigoid, pemphigus vulgaris, lichen planus erosive lichen planus, and cicatricial alopecia….JAK inhibitors are approved for alopecia areata, but not quite cicatricial alopecia yet.”

What is being discovered, Maloney expressed, is information regarding overlapping inflammatory pathways. She also noted hair regrowth has been observed among individuals with cicatricial alopecia.

To learn more about topics in dermatology presented at the 2025 SDPA Fall Conference, view our site’s latest conference coverage.

The quotes used in this session summary were edited for the purposes of clarity.

References

1. Incyte Announces Additional FDA Approval of Opzelura® (Ruxolitinib) Cream in Children Ages 2-11 with Atopic Dermatitis. Incyte. September 18, 2025. Accessed November 8, 2025. https://investor.incyte.com/news-releases/news-release-details/incyte-announces-additional-fda-approval-opzelurar-ruxolitinib.

2. Maloney G. Off-Label Usage of JAK Inhibitors. Presented at the Society of Dermatology Physician Associates (SDPA) Fall Conference, November 5-9, San Antonio, TX.