Concurrent chronic alopecia areata and severe atopic dermatitis successfully treated with upadacitinib

Asfour, Leila; Colla, Themis Getsos; Moussa, Anthony; Sinclair, Rodney

doi:10.1111/ijd.16316

Cited by 20 publications

(12 citation statements)

References 4 publications

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“…Asfour et al. [ 40 ] reported a patient with a 35-year history of relapsing–remitting AA and moderate-to-severe AD, who showed partial hair regrowth and remission of AD with baricitinib; however, the therapy had to be stopped after 6 weeks due to side effects (severe acne, migraines, recurrent herpes). After initiating treatment with upadacitinib, clearance of eczema was observed, as well as hair regrowth in areas that did not respond to previous therapy with baricitinib.…”

Section: Discussionmentioning

confidence: 99%

Alopecia Universalis in an Adolescent Successfully Treated with Upadacitinib—A Case Report and Review of the Literature on the Use of JAK Inhibitors in Pediatric Alopecia Areata

Kołcz

Żychowska

Sawińska

et al. 2023

Dermatol Ther (Heidelb)

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Alopecia areata (AA) is a cell-mediated autoimmune disease in which a cytotoxic T-cell response against hair follicles occurs. AA has been demonstrated to frequently co-exist with atopic dermatitis (AD), and the coincidence of atopy predisposes to a more severe course of the disease. To date, therapeutic options in AA, especially in the pediatric population, are mainly limited to corticosteroids, irritants, sensitizers, and immunosuppressive agents. Recently, innovative therapies have emerged, among which Janus kinase (JAK) inhibitors, effective in both AD and AA, appear to be the most promising. Here, a 14-year-old girl with alopecia universalis (AU) and mild AD is demonstrated, who was successfully treated with a selective JAK1 inhibitor, upadacitinib, which has been approved for the treatment of AD in adults and children aged 12 years and older. Resolution of eczema and complete hair regrowth was achieved after 3 months of therapy. Apart from transient mild leukopenia at weeks 4 and 8, no adverse events were noted. Data in the literature on the efficacy and safety of JAK inhibitors in the treatment of AA in the pediatric population is based on single case reports and case series. So far, topical tofacitinib and ruxolitinib, as well as systemic tofacitinib, ruxolitinib, and baricitinib have been used off-label in this indication in children. Upadacitinib is another effective treatment option with a good benefit–risk ratio for patients with AA, including cases coexisting with AD.

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Section: Discussionmentioning

confidence: 99%

Alopecia Universalis in an Adolescent Successfully Treated with Upadacitinib—A Case Report and Review of the Literature on the Use of JAK Inhibitors in Pediatric Alopecia Areata

Kołcz

Żychowska

Sawińska

et al. 2023

Dermatol Ther (Heidelb)

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“…To date, there is no literature reporting upadacitinib applied to AA or AD patients under 12 years of age, yet there is an ongoing clinical trial investigating the pharmacokinetics, safety and tolerability of upadacitinib in paediatric participants (aged between 2 and 12 years) with severe AD (NCT03646604). There are only 5 reports of AA cases treated with upadacitinib ( 8 – 11 ), in 4 of which the AA cases are concurrent with AD ( 8 – 10 ) and all of the 5 patients are adults. These patients were refractory to traditional treatments, such as cyclosporine, methotrexate, azathioprine, and glucocorticoids.…”

Section: Discussionmentioning

confidence: 99%

“…When switched to upadacitinib, both AA and AD were under effective control. Except for 1 patient who did not specify the dosage ( 8 ), the other patients resumed 30 mg daily of upadacitinib. At the follow-up visit (up to 4 months), the treatment was well tolerated in all subjects, with no side-effects.…”

Section: Discussionmentioning

confidence: 99%

Upadacitinib for Successful Treatment of Alopecia Universalis in a Child: A Case Report and Literature Review

Ren

2023

Acta Derm Venereol

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“…Four previous case reports, which included five patients, have been published on treatment of AA with upadacitinib. 9 – 11 , 24 All five patients had substantial improvement or total resolution of AA with upadacitinib 30 mg daily. In four patients, the primary indication for treatment was atopic dermatitis and resolution of AA was an unexpected but beneficial secondary outcome.…”

Section: Discussionmentioning

confidence: 95%

Successful treatment of concomitant alopecia universalis and Crohn’s disease with upadacitinib: A case report

Johnston

Poelman

2023

SAGE Open Medical Case Reports

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Alopecia areata is a non-scarring, autoimmune hair loss disorder that is associated with inflammatory bowel disease. Alopecia areata and inflammatory bowel disease may have a common pathogenic mechanism that involves the Janus kinase/STAT pathway. In addition, there are previous case reports of patients who developed alopecia areata while on biologic therapies for inflammatory bowel disease. JAK1 inhibitors are currently undergoing investigation as potential therapies for Crohn’s disease. Upadacitinib, an oral JAK1 inhibitor, has demonstrated efficacy in treating Crohn’s disease during phase III clinical trials. In this case report, we present a 23-year-old man with Crohn’s disease who previously developed alopecia areata while on adalimumab. He had near-complete resolution of his alopecia universalis after 7 months of treatment with upadacitinib while on concurrent ustekinumab for Crohn’s disease, which he had been taking for 16 months prior to starting upadacitinib. Upadacitinib may be a beneficial therapy for treating concomitant alopecia areata and Crohn’s disease.

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Concurrent chronic alopecia areata and severe atopic dermatitis successfully treated with upadacitinib

Cited by 20 publications

References 4 publications

Alopecia Universalis in an Adolescent Successfully Treated with Upadacitinib—A Case Report and Review of the Literature on the Use of JAK Inhibitors in Pediatric Alopecia Areata

Alopecia Universalis in an Adolescent Successfully Treated with Upadacitinib—A Case Report and Review of the Literature on the Use of JAK Inhibitors in Pediatric Alopecia Areata

Upadacitinib for Successful Treatment of Alopecia Universalis in a Child: A Case Report and Literature Review

Successful treatment of concomitant alopecia universalis and Crohn’s disease with upadacitinib: A case report

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