A case of atopic dermatitis with alopecia universalis in a patient treated with abrocitinib

Zhao, Jiahui; Liu, Lingling

doi:10.1016/j.jdcr.2022.02.027

Cited by 11 publications

(12 citation statements)

References 7 publications

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“…Both patients were enrolled into a long-term clinical trial termed JADE EXTEND after showing responsiveness to abrocitinib, noted by improvement in AD, in an initial shorter treatment window. The patients had noticeable hair regrowth occur at 12-14 weeks into the trial that maintained throughout the course of treatment ( 91 ).…”

Section: Second Generation Jak Inhibitorsmentioning

confidence: 99%

An overview of JAK/STAT pathways and JAK inhibition in alopecia areata

Lensing

Jabbari

2022

Front. Immunol.

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Alopecia Areata (AA) is a common autoimmune disease characterized by non-scarring hair loss ranging from patches on the scalp to complete hair loss involving the entire body. Disease onset is hypothesized to follow the collapse of immune privilege of the hair follicle, which results in an increase in self-peptide/MHC expression along the follicular epithelium. Hair loss is associated with infiltration of the hair follicle with putatively self-reactive T cells. This process is thought to skew the hair follicle microenvironment away from a typically homeostatic immune state towards one of active inflammation. This imbalance is mediated in part by the dominating presence of specific cytokines. While interferon-γ (IFNγ) has been identified as the key player in AA pathogenesis, many other cytokines have also been shown to play pivotal roles. Mechanistic studies in animal models have highlighted the contribution of common gamma chain (γc) cytokines such as IL-2, IL-7, and IL-15 in augmenting disease. IFNγ and γc cytokines signal through pathways involving receptor activation of Janus kinases (JAKs) and signal transducers and activators of transcription (STATs). Based on these findings, JAK/STAT pathways have been targeted for the purposes of therapeutic intervention in the clinical setting. Case reports and series have described use of small molecule JAK inhibitors leading to hair regrowth among AA patients. Furthermore, emerging clinical trial results show great promise and position JAK inhibitors as a treatment strategy for patients with severe or recalcitrant disease. Demonstrated efficacy from large-scale clinical trials of the JAK inhibitor baricitinib led to the first-in-disease FDA-approved treatment for AA in June of 2022. This review aims to highlight the JAK/STAT signaling pathways of various cytokines involved in AA and how targeting those pathways may impact disease outcomes in both laboratory and clinical settings.

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Section: Second Generation Jak Inhibitorsmentioning

confidence: 99%

An overview of JAK/STAT pathways and JAK inhibition in alopecia areata

Lensing

Jabbari

2022

Front. Immunol.

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“… 11 Notably, both patients achieved rapid and complete remission after switching to abrocitinib treatment. AA, whether occurring alone, 5 comorbid with AD, 3 , 7 or induced by drugs 6 that have failed to respond to other therapies, all showed significant improvement with abrocitinib treatment. In our cases, a patient with PG and another with HS achieved rapid remission after receiving abrocitinib in combination with traditional medicines, and this improvement persisted even after discontinuing the traditional medications.…”

Section: Discussionmentioning

confidence: 99%

“… 1 The JAK pathways play a crucial role in response to over 50 inflammatory cytokines and are also involved in the differentiation of naive T cells into various types of immune cells, such as Th1, Th2, and Th17 cells. 2 These processes are closely associated with the pathogenesis of a wide range of inflammatory immune-mediated diseases, 3 making these conditions theoretically treatable by JAK inhibitors. Abrocitinib, inhibitor of JAK1, has recently shown promising results in the off-label treatment of some skin diseases associated with JAK activity, including alopecia areata (AA), and others.…”

Section: Introductionmentioning

confidence: 99%

Abrocitinib as a Novel Treatment for Multiple Skin Disorders: 3 Case Reports and a Scoping Review

Chen,

Liang,

et al. 2024

CCID

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Janus kinase (JAK) inhibitors are increasingly being used in dermatology due to their broad potential in managing both local and systemic inflammation. More recently, abrocitinib, an oral JAK 1 inhibitor, has shown promising clinical efficacy in the treatment of various skin disorders beyond moderate to severe atopic dermatitis (AD). We firstly presented three cases, each with diagnosis of pyoderma gangrenosum (PG), livedoid vasculopathy (LV), or hidradenitis suppurativa (HS), and conducted a comprehensive scoping review of the available literature on the use of abrocitinib in the treatment of diverse skin disorders. We summarized a total of 16 skin disorders, including our cases. The results indicated that abrocitinib, whether used as monotherapy or in combination with other treatments, was effective and well-tolerated in these disorders. These findings expanded the range of diseases for which abrocitinib may serve as an alternative therapeutic choice.

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“…This review did not include two JAK‐1 inhibitors that proved effective in stimulating hair regrowth in AA, due to the small population size. Oral abrocitinib (100/200 mg daily) was administered to three patients (two females and one male aged 14, 46 and 33 years) suffering from AA and atopic dermatitis, for a median period of 56 weeks with no reported side‐effects 29,30 …”

Section: Discussionmentioning

confidence: 99%

“…Oral abrocitinib (100/200 mg daily) was administered to three patients (two females and one male aged 14, 46 and 33 years) suffering from AA and atopic dermatitis, for a median period of 56 weeks with no reported side-effects. 29,30 Five cases (three males and two females meanly aged 36 years) affected by AA, and in four of five cases by moderate-severe atopic dermatitis, were treated with oral upadacitinib 30 mg/daily (not specified in 1 case) for a mean time of 13 weeks with no reported AEs. 19,[31][32][33] Interestingly, one patient had previously ceased baricitinib due to AEs including severe acne, migraine, orolabial herpes simplex infection and lethargy.…”

Section: Discussionmentioning

confidence: 99%

Adverse events in patients treated with Jak‐inhibitors for alopecia areata: A systematic review

Sechi

Song

Dell'Antonia

et al. 2023

Acad Dermatol Venereol

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Recently, the impressive efficacy of JAK‐inhibitors (JAK‐I) in alopecia areata (AA) has been described in several studies; however, to date, there is limited information on the safety of JAK‐I in AA patients. For this reason, on 18 August 2022, a systematic review was performed to collect the premarketing and postmarketing data on the safety of JAK‐I in patients treated for AA, evaluating for each molecule the reported adverse events (AEs) in indexed literature and their frequency. The keywords ‘alopecia areata’ AND ‘Jak‐inhibitors OR Janus‐kinase Inhibitors’ were searched on PubMed, Embase and Cochrane databases. Of 407 studies retrieved, 28 papers met the requirements and were used in our review, including five RCTs and 23 case series; overall, 1719 patients were included, and the safety of 6 JAK‐I was assessed (baricitinib, brepocitinib, deuruxolitinib, ritlecitinib, ruxolitinib and tofacitinib). Systemic JAK‐I were well‐tolerated, most of the AEs were mild, and the withdrawal rate for AEs was very low and inferior to placebo in controlled studies (1.6% vs. 2.2%). Laboratory abnormalities represented 40.1% of AEs associated with oral JAK‐I, which mostly included the rise in cholesterol, transaminase, triglycerides, creatine phosphokinase (CPK) and sporadic cases of neutro/lymphocytopenia. The remaining AEs involved the respiratory tract (20.8%), the skin (17.2%), the urogenital (3.8%), or the gastroenterological (3.4%) tract. Increased rates of infections involved not only the upper (19.0%) and lower (0.3%) respiratory tract, but also the urogenital system (3.6%) and the skin (4.6%). Isolated cases of grade 3 to 4 AEs have been reported, including myocardial infarction, hypertensive urgencies, cellulitis, rhabdomyolysis, neutropenia and high elevation of creatinine kinase. No fatal outcomes were reported. AEs reported with topical formulation included scalp irritation and folliculitis. The main limit of this review is the lack of data related to postmarketing surveillance, which should be maintained on a long‐term basis.

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A case of atopic dermatitis with alopecia universalis in a patient treated with abrocitinib

Cited by 11 publications

References 7 publications

An overview of JAK/STAT pathways and JAK inhibition in alopecia areata

An overview of JAK/STAT pathways and JAK inhibition in alopecia areata

Abrocitinib as a Novel Treatment for Multiple Skin Disorders: 3 Case Reports and a Scoping Review

Adverse events in patients treated with Jak‐inhibitors for alopecia areata: A systematic review

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