Efficacy of tofacitinib in treatment of alopecia universalis in two patients

Gupta, Aditya K.; Carviel, Jessie; Abramovits, William

doi:10.1111/jdv.13598

Cited by 53 publications

(33 citation statements)

References 70 publications

(168 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the number of reports is small, and no randomized, placebo-controlled studies have yet been performed, the response in patients with severe alopecia (in which spontaneous remission is rare) strongly suggests a therapeutic effect. Not surprisingly, there have been several reports of relapse following initial improvement in patients treated with ruxolitinib and tofacitinib 196,197,200,202 , suggesting that an eventual therapeutic regimen may need to include long-term maintenance therapy. The overall positive results in these early clinical studies are supported by the results of JAK inhibition in a mouse model of alopecia areata and by an improved understanding of the pathogenesis of the disease.…”

Section: Discussionmentioning

confidence: 99%

Alopecia areata

Pratt

King

Messenger

et al. 2017

Nat Rev Dis Primers

580

528

View full text Add to dashboard Cite

Alopecia areata is an autoimmune disorder characterized by transient, non-scarring hair loss and preservation of the hair follicle. Hair loss can take many forms ranging from loss in well-defined patches to diffuse or total hair loss, which can affect all hair bearing sites. Patchy alopecia affecting the scalp is the most common type. Alopecia areata affects nearly 2% of the general population at some point during their lifetime. Skin biopsies of alopecia areata affected skin show a lymphocytic infiltrate in and around the bulb or the lower part of the hair follicle in anagen (hair growth) phase. A breakdown of immune privilege of the hair follicle is thought to be an important driver of alopecia areata. Genetic studies in patients and mouse models showed that alopecia areata is a complex, polygenic disease. Several genetic susceptibility loci were identified associated with signaling pathways that are important to hair follicle cycling and development. Alopecia areata is usually diagnosed based on clinical manifestations, but dermoscopy and histopathology can be helpful. Alopecia areata is difficult to manage medically, but recent advances in understanding the molecular mechanisms have revealed new treatments and the possibility of remission in the near future.

show abstract

Section: Discussionmentioning

confidence: 99%

Alopecia areata

Pratt

King

Messenger

et al. 2017

Nat Rev Dis Primers

580

528

View full text Add to dashboard Cite

show abstract

“…Early phase clinical trials and large retrospective studies indicate that tofacitinib 83–86 ruxolitinib and baricitinib 87,88 are effective for the spectrum of autoimmune forms of alopecia. However, symptoms recur upon drug discontinuation 89 , and tofacitinib may lose efficacy in some patients 90 . Topical ruxolitinib has also demonstrated efficacy in treatment of alopecia areata 91 and there is an ongoing clinical trial evaluating the efficacy of topical tofacitinib (NCT02812342).…”

Section: Alopecia Areatamentioning

confidence: 99%

Erratum: JAK inhibition as a therapeutic strategy for immune and inflammatory diseases

Schwartz¹,

Kanno²,

Villarino³

et al. 2018

Nat Rev Drug Discov

293

109

View full text Add to dashboard Cite

Proof provided by biological therapies that cytokines are truly key drivers of immune-mediated diseases has spurred effort in targeting their associated signaling pathways. Small-molecule drugs that inhibit Janus kinases (jakinibs), which are essential signaling mediators downstream of many pro-inflammatory cytokines, have gained traction as safe and efficacious options for the treatment of inflammation-driven pathologies like rheumatoid arthritis, psoriasis and inflammatory bowel disease. Building on the clinical success of first-generation jakinibs, second-generation compounds which claim greater selectivity are currently undergoing development and proceeding to clinical trials. However, important questions remain about the advantages and limitations of improved JAK selectivity, optimal routes and dosing regimens, and how best to identify patients that will benefit from jakinibs. This review will discuss the biology of jakinibs from a translational perspective, focusing on recent insights from clinical trials, the development of novel agents, and the use of jakinibs in a spectrum of immune and inflammatory diseases.

show abstract

“…Both JAK1 and JAK2 (ruxolitinib, baricitinib) and JAK3 (tofacitinib) inhibitors have been reported to effectively treat AA in various case reports [109][110][111][112].…”

Section: Janus Kinase Inhibitorsmentioning

confidence: 99%

New Modalities in the Treatment of Refractory Alopecia Areata

Kılıç¹

2017

Hair and Scalp Disorders

View full text Add to dashboard Cite

Alopecia areata (AA) is a common and complex T-cell-mediated inflammatory disorder. It may be patchy (localized), involve the entire scalp (alopecia totalis) or entire body (alopecia universalis). Alopecia totalis and universalis are often difficult to treat. Although many therapeutic options currently exist in alopecia areata, none of them are curative or preventive. Besides, none of them are approved by Food and Drug Administration (FDA). The disease unfortunately has an unpredictable course. The factors indicating a poor prognosis are the extent of hair loss at the presentation, long duration of the disease, and ophiasis pattern of hair loss. There are only a few randomized controlled studies conducted on recalcitrant AA. Recent research on immunology of hair follicle and recent developments in immunopathogenesis, together with the shared pathways of the disease with other autoimmune disorders, led investigators to focus on novel therapies that target specific immunological pathways. Herein, we will review shortly the current treatment options in recalcitrant alopecia areata based on recently published studies and then will focus on the recently developed broad-spectrum and targeted therapeutics.

show abstract

Efficacy of tofacitinib in treatment of alopecia universalis in two patients

Abstract: In our patients, tofacitinib successfully alleviated AU in the absence of significant adverse side-effects. We recommend that further study be required to establish safety and confirm efficacy.

Cited by 53 publications

References 70 publications

Alopecia areata

Alopecia areata

Erratum: JAK inhibition as a therapeutic strategy for immune and inflammatory diseases

New Modalities in the Treatment of Refractory Alopecia Areata

Contact Info

Product

Resources

About