Sequential Immunotherapy with Tofacitinib and Low-Dose IL-2 Induces Sustained Remission in Alopecia Areata: A Proof-of-Concept Monocentric Study

This proof-of-concept study investigated the effectiveness of sequential immunotherapy using tofacitinib and low-dose IL-2 in maintaining remission in alopecia areata (AA) patients after treatment withdrawal. Conducted at Xiangya Hospital, China, the study involved 4 refractory AA patients who had complete hair regrowth after at least 6 months of tofacitinib treatment. Following adjunctive IL-2 therapy, 3 patients maintained complete remission for 11–20 months, while 1 experienced localized recurrence at 5 months but managed it with low-dose tofacitinib. No adverse events were reported. The study suggests that this combination therapy may help reestablish immune tolerance and offer a strategy for drug-free remission, though larger trials are needed to confirm these findings.