Characteristics and Outcomes of Patients on Tofacitinib for Alopecia Areata or Rheumatoid Arthritis: A Retrospective Cohort Study

This retrospective cohort study compared 1,793 alopecia areata (AA) patients and 21,080 rheumatoid arthritis (RA) patients treated with tofacitinib. After matching for age, sex, and race, each cohort had 1,482 patients. The AA cohort was younger (mean age 38 vs. 61 years) and had fewer comorbidities. RA patients had higher rates of infections, thromboembolic events, and non-lymphoma/hematopoietic malignancies, while both cohorts had similar rates of myocardial infarction, stroke, and lymphomas/hematopoietic malignancies. The study emphasizes the need for careful consideration of tofacitinib's boxed warning when used off-label for AA and suggests larger clinical trials to further assess these risks. Limitations include potential biases and inability to control for all confounding variables.