Adjuvant Treatment with Oral Minoxidil for Refractory Alopecia Areata to JAK Inhibitors

The study explored the use of adjuvant oral minoxidil (AOM) for patients with severe alopecia areata (AA) who were unresponsive to Janus kinase inhibitors (JAKi) alone. It was observed that combining oral minoxidil with JAKi, such as tofacitinib or ruxolitinib, improved hair regrowth in patients who did not respond to JAKi monotherapy. The study presented 3 cases where AOM led to significant hair regrowth, as indicated by decreased Severity of Alopecia Tool (SALT) scores. The response to the adjuvant treatment was typically seen 3-6 months after initiation. The combination therapy may enhance the efficacy of JAKi, potentially reducing the need for higher doses and minimizing associated costs and risks. Further studies were suggested to optimize the use of oral minoxidil in combination with JAKi.