Tofacitinib for the treatment of alopecia areata in preadolescent children

In a study from 2019, four preadolescent children aged 8 to 10 years with severe alopecia areata (AA) were treated with the oral Janus kinase (JAK) inhibitor, tofacitinib. These patients, who had not responded to previous treatments, were given tofacitinib at a dose of 5 mg twice daily, except for one patient who started with 5 mg once daily but was later increased to the standard dose due to lack of improvement. After treatment periods ranging from 6 to 15 months, two patients achieved complete hair regrowth, one had 62% regrowth, and the fourth had minimal regrowth. No adverse events or abnormal laboratory test results were reported during the treatment period. The study suggests that tofacitinib may be a viable option for preadolescent children with AA after proper counseling about potential risks, including severe infection and malignancy.