Janus Kinase Inhibitors in Dermatology: A Systematic Review

February 2017 in “ Journal of the American Academy of Dermatology ”

Rony Shreberk‐Hassidim, Yuval Ramot, Abraham Zlotogorski

Janus kinase inhibitors JAK inhibitors alopecia areata psoriasis vitiligo dermatitis cutaneous T cell lymphoma lupus erythematosus

Studysummary This systematic review found that Janus kinase inhibitors have shown beneficial effects for psoriasis and alopecia areata, with promising preliminary results in other skin conditions, though more research is needed to define dosing and safety profiles. Our plain-language summary of this paper — not a Tressless recommendation.

This systematic review from 2017 evaluated the use of Janus kinase (JAK) inhibitors in dermatology by analyzing 134 articles, including 78 original articles and 18 clinical trials. JAK inhibitors showed beneficial results for psoriasis, comparable to etanercept, and favorable outcomes for alopecia areata. Preliminary positive results were also noted for vitiligo, dermatitis, graft versus host disease, cutaneous T cell lymphoma, and lupus erythematosus. The most common adverse events were infections, particularly nasopharyngitis and upper respiratory tract infections. However, the review highlighted gaps in knowledge regarding the correct dosing and safety profile of JAK inhibitors, indicating a need for further trials.

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research Tofacitinib for the Treatment of Alopecia Areata and Variants in Adolescents

139 citations , November 2016 in “Journal of the American Academy of Dermatology”

In this retrospective review, tofacitinib treatment was associated with clinically significant hair regrowth in most adolescent patients with alopecia areata, though limitations suggest further studies are needed to confirm these findings.

research Tofacitinib for the Treatment of Severe Alopecia Areata and Variants: A Study of 90 Patients

238 citations , November 2016 in “Journal of The American Academy of Dermatology”

In this study, tofacitinib was reported to improve scalp hair regrowth in patients with severe alopecia areata, alopecia totalis, and alopecia universalis, showing a higher response in alopecia areata.

research Oral Ruxolitinib Induces Hair Regrowth in Patients with Moderate-to-Severe Alopecia Areata

196 citations , September 2016 in “JCI insight”

This study explored the effectiveness of the oral JAK1/2 inhibitor ruxolitinib in treating patients with moderate-to-severe alopecia areata, building on prior success with JAK inhibitors in mice, but results are not reported in this abstract.

$Successful Treatment of Refractory Alopecia Areata Universalis and Psoriatic Arthritis, But Not Plaque Psoriasis with Tofacitinib in a Young Woman$

research Successful Treatment of Refractory Alopecia Areata Universalis and Psoriatic Arthritis, But Not Plaque Psoriasis with Tofacitinib in a Young Woman

24 citations , June 2016 in “Acta dermato-venereologica”

In this case report, tofacitinib was associated with new hair growth on psoriasis lesions after three months of treatment.

research Efficacy of Tofacitinib in Treatment of Alopecia Universalis in Two Patients

51 citations , June 2016 in “Journal of the European Academy of Dermatology and Venereology”

In this study, tofacitinib treatment was associated with significant hair regrowth in two patients with alopecia universalis over eight months, with minimal adverse effects reported.

research Treatment of an Alopecia Areata Patient with Tofacitinib Results in Regrowth of Hair and Changes in Serum and Skin Biomarkers

70 citations , April 2016 in “Experimental Dermatology”

In this study, oral tofacitinib treatment led to significant hair regrowth and changes in skin and blood biomarkers in a patient with alopecia areata.

research Transient Efficacy of Tofacitinib in Alopecia Areata Universalis

39 citations , April 2016 in “Case Reports in Dermatology”

This study observed initial hair regrowth in a businessman with alopecia areata universalis treated with tofacitinib, but the effect diminished, leading to renewed hair loss.

research A Systematic Review of Pulse Steroid Therapy for Alopecia Areata

50 citations , January 2016 in “Journal of the American Academy of Dermatology”

This systematic review of pulse corticosteroid therapy for alopecia areata found relatively low complete response rates, but responders experienced low relapse rates, indicating potential benefits for patients with favorable prognostic factors.

research Rapid Skin Repigmentation on Oral Ruxolitinib in a Patient with Coexistent Vitiligo and Alopecia Areata

157 citations , December 2015 in “Journal of the American Academy of Dermatology”

This case study reported significant but temporary hair regrowth and skin repigmentation in a patient with vitiligo and alopecia areata during treatment with oral ruxolitinib.

research Topical Ruxolitinib for the Treatment of Alopecia Universalis

96 citations , December 2015 in “JAMA dermatology”

This article discusses the potential of topical ruxolitinib as a treatment for alopecia universalis and acknowledges the need for alternatives to systemic JAK inhibitors due to the risk of serious side effects.

research Tofacitinib Citrate for the Treatment of Nail Dystrophy Associated with Alopecia Universalis

41 citations , December 2015 in “JAMA Dermatology”

Tofacitinib citrate improved nail dystrophy and pain in patients with alopecia universalis without causing side effects.

research Pharmacologic Inhibition of JAK-STAT Signaling Promotes Hair Growth

159 citations , October 2015 in “Science Advances”

This study observed that applying JAK-STAT pathway inhibitors to mouse and human skin led to rapid hair growth by inducing the anagen phase of hair follicles.

research Reversal of Alopecia Areata Following Treatment With the JAK1/2 Inhibitor Baricitinib

184 citations , February 2015 in “EBioMedicine”

This study observed that baricitinib treatment led to significant improvement in a patient's alopecia areata symptoms and suggests further clinical trials to explore its potential as a treatment.

research The Genetics Of Alopecia Areata: New Approaches, New Findings, New Treatments

62 citations , January 2015 in “Journal of Dermatological Science”

This review summarizes the current genetic research on alopecia areata, including potential new therapeutic strategies, but reports no new clinical findings.

research Alopecia Areata Is Driven by Cytotoxic T Lymphocytes and Is Reversed by JAK Inhibition

701 citations , August 2014 in “Nature medicine”

This study found that JAK inhibitors promote hair regrowth in both mice and human alopecia areata cases by blocking key immune pathways involved in disease development.

research Killing Two Birds with One Stone: Oral Tofacitinib Reverses Alopecia Universalis in a Patient with Plaque Psoriasis

185 citations , June 2014 in “Journal of Investigative Dermatology”

This case report describes complete hair regrowth in a patient with alopecia universalis and improved psoriasis after treatment with the oral Janus kinase inhibitor, tofacitinib.