Oral JAK inhibitors used for alopecia areata, atopic dermatitis and vitiligo share a pre-treatment checklist. Before starting, screen for latent tuberculosis and hepatitis B and C, check a full blood count, liver tests and lipids, review vaccination status and cardiovascular and thrombotic risk factors, and confirm the patient is not pregnant. Repeat blood tests and lipids after the first few months of treatment. Patients over 65, smokers and those with cardiovascular or VTE risk need a careful risk-benefit discussion, in line with current label warnings.
- Screen for latent TB and hepatitis B and C before the first dose.
- Check full blood count, liver tests and a lipid profile at baseline and again early in treatment.
- Record cardiovascular and VTE risk factors, smoking and age, and discuss them with the patient.
- Bring vaccinations up to date, avoiding live vaccines once treatment starts.
Why it matters
JAK inhibitors are spreading across dermatology, and the screening is the same whichever skin disease prompts them.
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