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Should we consider the JAK inhibitors more broadly immunosuppressive than the biologics?

JAK Inhibitors

You. A lot of clinicians have questions about how immunosuppressive are Janus kinase inhibitors compared to some of the biologic agents that we use, whether it be dupiliumab or il 13 inhibitors that are coming along for atopic dermatitis or some of the injectable biologics that we have for psoriasis. You really have to look at the specific Janus kinase inhibitor and look at what Janus kinases are being inhibited, realizing that even if they're selective, there may be some spillover into other Janus kinase enzymes being inhibited. And then you have to look at what's downstream from that Janus kinase stat signaling, what the end effect is, because there are many different cytokines and mediators that interact with different Janus kinase inhibitors, and they have different implications in terms of what they signal downstream. So, for example, if you're inhibiting Janus kinase one, you're going to have a modulatory effect on interleukin four, interleukin 13, interleukin two, interleukin 615 22, 31, interferons, some of the interferons and TSLP, thymic stromal lymphopoietin. So you have a broad inhibition or modulation of the effects of those different cytokines. So in general, yes, Januskinase inhibitors are more modulating of the immune system than targeted antibodies that affect specific, but you still have to look at each individual case.