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

    February 2026 in “ Frontiers in Immunology ”
    Zulin Wan, Ying Wang, Dingquan Yang
    Studysummary This case report highlights significant improvement in a patient with severe alopecia areata who responded well to ivarmacitinib after a suboptimal response to another JAK inhibitor, tofacitinib, suggesting ivarmacitinib as a potential alternative for tofacitinib-refractory cases.
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    Research cited in this study 14

    1. Ivarmacitinib for the Treatment of Adults with Severe Alopecia Areata: Results from a Phase 3 Trial Journal of the American Academy of Dermatology · 2025
    2. Considerations for the Treatment Strategy of Relapse After Tofacitinib Therapy in Alopecia Areata Journal of Cosmetic Dermatology · 2025
    3. Alopecia Areata: Pathogenesis, Diagnosis, And Therapies MedComm · 2025
    4. Baricitinib for the Treatment of Moderate-To-Severe Alopecia Areata Balkan Medical Journal · 2025
    5. Screening for Latent Infectious Disease in Patients with Alopecia Areata Before Initiating JAK Inhibitors Therapy: A Single-Center Real-World Retrospective Study Frontiers in medicine · 2023
    6. Dupilumab Therapy for Alopecia Areata in a 4-Year-Old Patient Resistant to Baricitinib Frontiers in Medicine · 2023
    7. Efficacy and Safety of Ritlecitinib in Adolescents with Alopecia Areata: Results from the ALLEGRO Phase 2b/3 Randomized, Double-Blind, Placebo-Controlled Trial Pediatric Dermatology · 2023
    8. Switching Between Tofacitinib and Baricitinib in Alopecia Areata: A Review of Clinical Response Journal of the American Academy of Dermatology · 2023
    9. Efficacy and Safety of Baricitinib in Patients with Severe Alopecia Areata Over 52 Weeks in Phase III Trials American Journal of Clinical Dermatology · 2023
    10. Ideal JAK Inhibitor for Alopecia Areata: Baricitinib, Tofacitinib, Ritlecitinib, or Ifidancitinib - Revisiting the Immunomechanisms of the JAK Pathway Indian Dermatology Online Journal · 2023
    11. Alopecia Areata: An Update on Etiopathogenesis, Diagnosis, and Management Clinical Reviews in Allergy & Immunology · 2021
    12. Selective Inhibition of JAK3 Signaling Is Sufficient to Reverse Alopecia Areata JCI insight · 2021
    13. Experience with Oral Tofacitinib in Severe Alopecia Areata with Different Clinical Responses Journal of Cosmetic Dermatology · 2021
    14. Ruxolitinib for the Treatment of Severe Alopecia Areata Journal of the American Academy of Dermatology · 2018