Tofacitinib for Treatment of Alopecia Areata: Real-world Evidence and Factors Associated with Therapeutic Response

Abstract

Alopecia areata (AA) is a common non-scarring type of alopecia. The severity of AA varies from mild to severe cases of generalized alopecia of scalp and body (1). Awide variety of treatments have been used in management of AA (2). Severe and extensive cases of AA, are com-monly treated with systemic drugs, including corticoste-roids (3) or immunosuppressive agents (4). However, lack of response and side-effects are often associated with these treatments. Janus kinase inhibitors (JAKi) have emerged as an alternative for treatment of severe cases of AA, which act via intracellular interruption of the JAK-STAT pathway (5). Tofacitinib is a potent, selective JAKi that preferentially inhibits JAK1 and JAK3 (6). Al though this drug has been used previously as an off-label treatment for AA (7, 8), real-world data are scarce (9). Therefore, the aim of this study is to assess the effectiveness and safety of oral tofacitinib treatment in a prospective cohort of patients with severe AA in a real-world setting.