Significant Improvement With Ivarmacitinib After Suboptimal Response to Tofacitinib in Severe Alopecia Areata: A Case Report and Literature Review

This case report discusses the effectiveness of ivarmacitinib, a highly selective JAK1 inhibitor, in treating severe alopecia areata (AA) in a 26-year-old female who had a suboptimal response to tofacitinib. After switching to ivarmacitinib, her SALT score improved significantly from 100 to 35, indicating substantial hair regrowth. The report suggests that ivarmacitinib's higher JAK1 selectivity may enhance its efficacy and tolerability compared to tofacitinib. It proposes that switching JAK inhibitors could be a viable strategy for managing severe AA, though further studies with larger sample sizes are necessary to validate these findings.