Case Report: Successful Treatment of Alopecia Universalis With Tofacitinib and Increased Cytokine Levels: Normal Therapeutic Reaction or Danger Signal?
June 2022
in “
Frontiers in Immunology
”
alopecia universalis tofacitinib cytokines Th1 cytokines IFN-γ TNF-α IL12p70 Th2 cytokines IL-4 IL-6 IL-10 Th17 cytokines IL-17 Severity of Alopecia Tool SALT Alopecia Areata Investigator Global Assessment AA-IGA alopecia Xeljanz interferon gamma tumor necrosis factor alpha interleukin 12 interleukin 4 interleukin 6 interleukin 10 interleukin 17
TLDR Tofacitinib regrew hair in a man with total hair loss but raised cytokine levels, needing more research on possible side effects.
A 53-year-old man with severe Alopecia Universalis (AU), a condition causing total hair loss, was treated with the drug tofacitinib, leading to hair regrowth over 24 weeks and a significant decrease in his Severity of Alopecia Tool (SALT) and Alopecia Areata Investigator Global Assessment (AA-IGA™) scores to zero. However, the treatment also resulted in a significant increase in peripheral blood cytokine levels, including Th1 cytokines IFN-γ, TNF-α, IL12p70, Th2 cytokines IL-4, IL-6, IL-10, and Th17 cytokines IL-17. These levels decreased after discontinuation of tofacitinib, suggesting potential unknown adverse reactions. The study concludes that while tofacitinib is a promising treatment for AU, more research is needed to understand the increase in cytokine levels during treatment and its potential adverse effects.
