Compounding Topical JAK Inhibitors: How important is the pharmacist ?

Compounding Topical JAK Inhibitors

 

As a hair dermatologist, I frequently ask the pharmacist to compound topical medications for my patients. Generally, my prescription tells the pharmacist the name of the drug I need compounded and the concentration I am suggesting. Unless I specifically say what to mix the medicine into (i.e compound into Vaseline ointment, orcream base or a liposomal base) an experience compounding pharmacist will choose what they think is best). There are many ways that the pharmacist can compound the medicine.

I was very interested to note that in a recent study of topical JAK inhibitors, one patient with advanced alopecia areata had no response to 2 % tofacitinib formulated in a cream base but had a marked 95 % regrowth when the tofacitinib was made up in a liposomal base

Conclusion

The compounding pharmacist plays and important role in helping to mix medications. As far as the JAK inhibitors go, advice from a compounding pharmacist can very helpful. More studies are needed to determine whether prescribing topical tofacitinib in a liposomal base is preferred over a cream base.

Reference

Bayarat et al. Topical Janus kinase inhibitors for the treatment of pediatric alopecia areata. J Am Acad Dermatol 2017; 77(1):167-169