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

    April 2018 in “ Journal of Investigative Dermatology ”
    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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