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

    Avi Bitterman, Ali Jabbari, J. Chen, Annemieke de Jong, Raphael Clynes, Julian Mackay‐Wiggan, Angela M. Christiano
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    TLDR Tofacitinib helped most patients with alopecia areata regrow hair and changes in immune cells were linked to the treatment's effectiveness.
    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.
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