Molecular Correlation With Clinical Outcomes in an Open Label Clinical Trial of Oral Tofacitinib in Patients With Alopecia Areata

In a 2018 open label clinical trial, 12 patients with moderate to severe alopecia areata were treated with oral tofacitinib. The study found that 8 patients experienced over 50% hair regrowth, 3 had partial regrowth, and 1 showed no regrowth after the treatment. Gene expression and T cell receptor (TCR) clonality analyses from scalp biopsies correlated with these clinical outcomes. Specifically, there was a significant decrease in TCR clonality, and responders showed a reduction in expanded scalp CD8+ T cell clones, which was not seen in the non-responder. These results suggest that tofacitinib can lead to significant improvements in alopecia areata, supporting the potential for larger, placebo-controlled trials using JAK inhibitors for this condition.