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

The study conducted from 2018 to 2020 involved 47 Asian Arab patients with severe alopecia areata (AA), 41 of whom completed the treatment with tofacitinib, a Janus kinase inhibitor. The Severity of Alopecia Tool (SALT) score was used to measure the response to treatment. Results showed complete hair regrowth in 18 patients (41.86%), partial regrowth in 11 patients (25.58%), and no response in 12 patients (27.9%), with most non-responders belonging to the alopecia universalis group. Adverse events were observed in 17% of the patients, but none required hospitalization. At the end of the study, 35 participants (74.47%) were still taking oral tofacitinib. The study found that the severity and duration of AA did not predict hair regrowth, but the duration of treatment was significant, with complete responders having an average treatment duration of 14 months. The study suggests that tofacitinib therapy should be continued for at least 12 months before considering discontinuation. Maintenance therapy after complete regrowth was found to be safe and effective in preventing hair loss recurrence. The study concludes that tofacitinib is a promising treatment for AA, including highly refractory, chronic cases, but further large-scale studies are needed to confirm these results.