Treatment of Severe Alopecia Areata with Oral Tofacitinib: A Case Series

The document reports a retrospective study on the efficacy and tolerability of oral tofacitinib, a Janus kinase inhibitor, in treating severe alopecia areata (AA). The study included 16 patients (10 females and 6 males) with a mean age of 30.2 years, who had more than 50% hair loss and were previously unresponsive to various treatments. They were treated with tofacitinib at doses of 10-15 mg/day. The results showed that 62.5% (10 out of 16) of the patients achieved a 50% improvement from baseline according to the severity of alopecia tool (SALT50). The study found that patients with persistent AA had a significantly higher frequency of being poor responders to the treatment. Mild transient side effects were reported, but overall, the treatment was well-tolerated. The conclusion suggests that oral tofacitinib could be an effective and tolerable treatment option for some patients with severe and refractory AA, but further research is needed to determine the optimal dosage, treatment duration, and to identify factors predicting poor response to tofacitinib treatment.