Experience with Oral Tofacitinib in Severe Alopecia Areata with Different Clinical Responses

    February 2021 in “ Journal of Cosmetic Dermatology ”
    Didem Dinçer Rota, Mehmet Ali Can Emeksiz, Fatma Gülru Erdoğan, Dilsun Yıldırım
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    TLDR Oral tofacitinib helped regrow hair in over half of the patients with severe alopecia, but relapses and side effects were common.
    In a study of 13 patients with severe alopecia areata (AA) and alopecia universalis (AU), oral tofacitinib treatment resulted in hair growth in 61.5% of the participants, with 53.8% showing a good response indicated by a 76%-100% change in SALT score. The treatment was more effective for AA than AU, with a 38.5% resistance rate observed. Relapses were common, occurring on average four months after stopping treatment. Side effects included acneiform eruption and oily skin in 69.2% of patients, and elevated transaminases in 23.0%. Continuous use of tofacitinib was necessary to maintain hair growth, and the study suggested that early treatment initiation could lead to better outcomes. The study was limited by its single-center design and lack of a control group.
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