Refractory Alopecia in Lupus Treated with Tofacitinib: A Case-Based Review

May 2023 in “ Clinical Rheumatology ”

Rajdeep Sarkar, Prakashini MV, Naga Hinduja, Mitanjali Sethy, H K Kar, Sakir Ahmed

tofacitinib Janus kinase inhibitor refractory alopecia systemic lupus erythematosus glucocorticoids JAK inhibitors Xeljanz

Studysummary This case report highlights a 33-year-old female with systemic lupus erythematosus and refractory alopecia who experienced significant hair regrowth after treatment with tofacitinib, maintained even after glucocorticoid tapering over two years.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

This case-based review discusses the successful use of tofacitinib, a Janus kinase inhibitor, in treating refractory alopecia in a 33-year-old female with systemic lupus erythematosus (SLE). The patient experienced significant hair regrowth, which was sustained over a 2-year follow-up, even after stopping glucocorticoids. The review also explores existing literature, indicating that JAK inhibitors may be a promising treatment option for alopecia in SLE patients.

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research Two Phase 3 Trials of Baricitinib for Alopecia Areata

148 citations , March 2022 in “The New England Journal of Medicine”

In two phase 3 trials, this study found that oral baricitinib significantly improved hair regrowth compared to placebo in adults with severe alopecia areata after 36 weeks, though longer trials are needed to ascertain its long-term efficacy and safety.

$Case Report: Reversal of Long-Standing Refractory Diffuse Non-Scarring Alopecia Due to Systemic Lupus Erythematosus Following Treatment With Tofacitinib$

research Case Report: Reversal of Long-Standing Refractory Diffuse Non-Scarring Alopecia Due to Systemic Lupus Erythematosus Following Treatment With Tofacitinib

6 citations , April 2021 in “Frontiers in Immunology”

This study presents the first documented case of dramatic hair regrowth in a systemic lupus erythematosus patient with refractory alopecia following tofacitinib therapy, suggesting a potential new application for JAK inhibitors in difficult-to-treat cutaneous SLE manifestations.

research Efficacy of JAK 1/2 Inhibition in the Treatment of Diffuse Non-Scarring Alopecia Due to Systemic Lupus Erythematosus

16 citations , January 2020 in “Annals of the rheumatic diseases”

In this study, baricitinib improved the resolution of arthritis or rash in patients with systemic lupus erythematosus, but outcomes for skin involvement like alopecia were not reported.

research Janus Kinase Inhibitors for the Treatment of Severe Alopecia Areata: An Open-Label Comparative Study

66 citations , December 2018 in “Dermatology”

This study found that oral JAK inhibitors, ruxolitinib and tofacitinib, are effective and well-tolerated for treating severe alopecia areata, with a similar degree of hair regrowth and relapse rates, but ruxolitinib induced faster initial hair regrowth.

research Review of Quality of Life Studies in Women with Alopecia

58 citations , January 2018 in “International Journal of Women's Dermatology”

This review discusses the psychological impact of alopecia on women and reports no new clinical findings, highlighting the effect on self-esteem and quality of life.

research Recovery of Nail Dystrophy: Potential New Therapeutic Indication of Tofacitinib

13 citations , February 2017 in “Clinical rheumatology”

This report suggests that tofacitinib may be beneficial for patients with nail disease unresponsive to other treatments.

research Tofacitinib for the Treatment of Severe Alopecia Areata and Variants: A Study of 90 Patients

238 citations , November 2016 in “Journal of The American Academy of Dermatology”

In this study, tofacitinib was reported to improve scalp hair regrowth in patients with severe alopecia areata, alopecia totalis, and alopecia universalis, showing a higher response in alopecia areata.

research Safety and Efficacy of the JAK Inhibitor Tofacitinib Citrate in Patients with Alopecia Areata

222 citations , September 2016 in “JCI insight”

This research overview highlights that although JAK inhibitors show promise as potential treatments for alopecia areata based on recent insights into the disease mechanism, their efficacy has not yet been thoroughly evaluated in a systematic manner.

research Non-Scarring Patchy Alopecia in Patients with Systemic Lupus Erythematosus Differs from That of Alopecia Areata

30 citations , October 2013 in “Lupus”

This study identified distinct clinical and dermatoscopic features to differentiate non-scarring patchy alopecia in SLE from alopecia areata, emphasizing the value of serological tests in diagnosis.

research Severe Diffuse Non-Scarring Hair Loss in Systemic Lupus Erythematosus: Clinical and Histopathological Analysis of Four Cases

15 citations , December 2011 in “Journal of the European Academy of Dermatology and Venereology”

In this study, severe diffuse hair loss in patients with systemic lupus erythematosus was associated with distinct clinical, dermoscopic, and histopathological features, which improved alongside treatment of the underlying condition.

Cross-Sectional Study of Hair Loss Patterns in 122 Korean Systemic Lupus Erythematosus Patients: A Frequent Finding of Non-Scarring Patch Alopecia

research Cross-Sectional Study of Hair Loss Patterns in 122 Korean Systemic Lupus Erythematosus Patients: A Frequent Finding of Non-Scarring Patch Alopecia

34 citations , June 2007 in “The Journal of Dermatology”

This study observed that non-scarring diffuse hair loss was common in systemic lupus erythematosus patients, but did not find a significant relationship with the SLE Disease Activity Index.