The efficacy and safety of tofacitinib in patients with alopecia totalis = The efficacy and safety of tofacitinib in patients with alopecia totalis

다국어 초록 (Multilingual Abstract)

Background: In a mouse model of alopecia areata(AA), CD8+NKG2D+ T cells were shown to be central in AA, causing up-regulation of IL-15 in hair follicles and ultimately production of INF-γ. As downstream regulators of INF-γ and IL-15, JAK inhibitors have been shown to eliminate the interferon signature and reverse disease.
Objectives: We aimed to evaluate the safety and efficacy of the JAK 1/3 inhibitor, tofacitinib, in a series of patients with recalcitrant alopecia totalis (AT).
Methods: This is a prospective open label study performed. Nine recalcitrant AA patients with a total baldness, unresponsive to other therapeutic modalities were included and had taken 5mg tofacitinib twice daily for 6months. The endpoint at 6 months was assessed by the percent change in Severity of Alopecia Tool(SALT) score during treatment.
Results: Three patients who experienced hair growth were judged as responders showing 25% to 75% regrowth at 6 months. The patients with a shorter duration of current AT and more preserved hair follicles showed better efficacy in tofacitinib. The relationship between of age of onset and hair growth improvement also showed positive relationship pattern.
Conclusion: In this study, the response rate was unsatisfactory. However, as the patients in this study did not respond to any other treatments of AA, tofacitinib might be considered as an alternative treatment of recalcitrant AA.