An Open-Label Pilot Study to Evaluate the Efficacy of Tofacitinib in Moderate to Severe Patch-Type Alopecia Areata, Totalis, and Universalis

In a pilot study from July 1, 2018, Tofacitinib, a JAK inhibitor, was evaluated for its efficacy in treating moderate to severe alopecia areata (AA), totalis (AT), and universalis (AU) in 12 patients, with 11 completing the study. Initially prescribed at 5mg twice daily, the dosage was increased to 10mg for non-responders. The results showed that 8 patients experienced ≥50% hair regrowth, 3 had <50% regrowth, and 1 showed no regrowth, as measured by the Severity of Alopecia Tool (SALT) score, with the average time to reach the primary efficacy endpoint being 32 weeks. The study concluded that Tofacitinib could be a potential treatment for AA, as gene expression profiles and Alopecia Areata Disease Activity Index (ALADIN) scores correlated with clinical response, but it noted the need for larger trials to confirm these findings. The study was limited by its small sample size and open-label design.