Systemic Tofacitinib Treatment in Pediatric Patients with Resistant Alopecia Areata

January 2024 in “ Dermatologic therapy ”

Eda Öksüm Solak, Murat Borlu

tofacitinib Janus kinase inhibitor JAK inhibitor alopecia areata Severity of Alopecia Tool SALT score upper respiratory infection AA

From the encyclopedia

Tofacitinib →

a JAK inhibitor for alopecia areata and other autoimmune conditions

Alopecia Areata →

autoimmune disorder causing patchy hair loss

Studysummary In this study, pediatric patients with alopecia areata treated with systemic tofacitinib showed significant improvement at 12 months, but the small sample size and retrospective design limit conclusions about its effectiveness. Our plain-language summary of this paper — not a Tressless recommendation.

The research article discusses a retrospective study on the use of systemic tofacitinib, a Janus kinase (JAK) inhibitor, for treating resistant alopecia areata (AA) in pediatric patients. The study involved 9 patients, average age 14.6 years, treated between 2019 and 2023. Results showed significant improvements in alopecia, especially at the 12-month mark, with 71.4% of the 7 patients who continued treatment for 12 months showing 50% or more improvement in Severity of Alopecia Tool (SALT) score. Only one patient reported an upper respiratory infection as a side effect. The study suggests that oral tofacitinib is a safe option for resistant pediatric AA patients, but long-term treatment might be necessary for optimal clinical response. The study's retrospective design and small patient cohort are significant limitations, and larger randomized studies are needed to further explore the efficacy and potential of JAK inhibitors in pediatric AA treatment.

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Research cited in this study

16 / 16 results

$Real-World Experience and Long-Term Evaluation of Tofacitinib in Refractory Alopecia Areata: A Prospective, Open-Label, Single-Center Study in Asian Arab Population$

research Real-World Experience and Long-Term Evaluation of Tofacitinib in Refractory Alopecia Areata: A Prospective, Open-Label, Single-Center Study in Asian Arab Population

2 citations , September 2022 in “Dermatologic Therapy”

In this study, tofacitinib showed a mixed response in treating refractory alopecia areata, with some patients experiencing complete or partial hair regrowth and others showing no response, particularly those with alopecia universalis.

research Clinical Response to Oral Tofacitinib in Pediatric Patients With Alopecia Areata

10 citations , August 2022 in “JAAD Case Reports”

This research abstract describes alopecia areata as an autoimmune disease causing hair loss due to an inflammatory response mediated by the JAK/STAT signaling pathway. The condition, which affects young people disproportionately, lacks a cure and entails significant psychosocial challenges, despite varied treatment attempts.

research Oral Tofacitinib for the Treatment of Alopecia Areata in Pediatric Patients

13 citations , November 2021 in “Pediatric Dermatology”

This study found that oral tofacitinib was effective and well tolerated for treating alopecia areata in most pediatric patients, with nearly 73% experiencing hair regrowth.

research Benefit and Risk Profile of Tofacitinib for the Treatment of Alopecia Areata: A Systematic Review and Meta-Analysis

54 citations , September 2019 in “Journal of the European Academy of Dermatology and Venereology”

This study found that tofacitinib shows reasonable effectiveness for treating alopecia areata with mild adverse effects, although more large-scale randomized trials are needed to fully assess its safety and efficacy.

research JAK Inhibitors for Alopecia Areata: A Systematic Review and Meta-Analysis

130 citations , February 2019 in “JEADV. Journal of the European Academy of Dermatology and Venereology/Journal of the European Academy of Dermatology and Venereology”

This study found that JAK inhibitors for alopecia areata showed promising response rates, with 72.4% of 289 cases responding, and oral administration achieving better outcomes than topical treatment, but recurrence occurred when treatment stopped. Further large-scale studies are needed to confirm these findings.

research JAK Inhibitors for Treatment of Alopecia Areata

63 citations , July 2018 in “The journal of investigative dermatology/Journal of investigative dermatology”

In this review, the researchers reported that JAK inhibitors, originally approved by the FDA for other uses, have shown effectiveness in reversing hair loss in patients with moderate to severe alopecia areata, based on current preclinical and clinical studies.

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

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

130 citations , February 2018 in “Journal of Investigative Dermatology”

This study found that tofacitinib led to ≥50% hair regrowth in eight out of twelve patients with moderate to severe alopecia areata, suggesting a potential benefit for using JAK inhibitors in treating this condition.

research Alopecia Areata: Overview and Insights from January 2018

290 citations , December 2017 in “Journal of The American Academy of Dermatology”

This article reviews the epidemiology, clinical evaluation, and pathogenesis of alopecia areata and highlights recent advancements, but it does not report new clinical findings.

research Treatment of Alopecia Areata With Tofacitinib

78 citations , March 2017 in “JAMA Dermatology”

Tofacitinib helped regrow hair in people with severe alopecia, but side effects occurred and benefits stopped after treatment ended.

research Tofacitinib for the Treatment of Alopecia Areata and Variants in Adolescents

139 citations , November 2016 in “Journal of the American Academy of Dermatology”

In this retrospective review, tofacitinib treatment was associated with clinically significant hair regrowth in most adolescent patients with alopecia areata, though limitations suggest further studies are needed to confirm these findings.

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 Alopecia Areata Is Driven by Cytotoxic T Lymphocytes and Is Reversed by JAK Inhibition

701 citations , August 2014 in “Nature medicine”

This study found that JAK inhibitors promote hair regrowth in both mice and human alopecia areata cases by blocking key immune pathways involved in disease development.

research Killing Two Birds with One Stone: Oral Tofacitinib Reverses Alopecia Universalis in a Patient with Plaque Psoriasis

185 citations , June 2014 in “Journal of Investigative Dermatology”

This case report describes complete hair regrowth in a patient with alopecia universalis and improved psoriasis after treatment with the oral Janus kinase inhibitor, tofacitinib.

research Alopecia Areata: Clinical Presentation, Diagnosis, and Unusual Cases

109 citations , May 2011 in “Dermatologic Therapy”

This article reviews the characteristics, associations, and diagnostic criteria for alopecia areata and reports no new clinical findings; the authors note the disease's unpredictable course and variable prognosis.

research Juvenile Versus Maturity-Onset Alopecia Areata: A Comparative Retrospective Clinical Study

164 citations , November 1989 in “Clinical and Experimental Dermatology”

This retrospective study found that juvenile alopecia areata is more severe and has a worse prognosis than maturity-onset alopecia areata.