The evaluation of JAK inhibitors on effect and safety in alopecia areata: a systematic review and meta-analysis of 2018 patients

Mao, Mei-Qi; Ding, Yuxin; Jing, Jing; Tang, Zhenwei; Miao, Yujie; Yang, Xiaoshuang; Chen, Yuhong; Chen, S.; Wu, Xianjie; Zhang, Lu

doi:10.3389/fimmu.2023.1195858

Cited by 7 publications

(2 citation statements)

References 55 publications

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“…Furthermore, based on our clinical experience, we found that females and elders were more vulnerable to the adverse effects of corticosteroids. The patient in our case refused glucocorticoid therapy because of obesity and menstrual disorders that might be caused by the inability to receive glucocorticoid therapy; (3) several reviews on the overall safety of JAK inhibitors have been published recently, suggesting that JAKi has good security with a low risk of venous thromboembolism, cardiac events, and cancer ( 13 – 17 ). As such, follow-up according to guidelines greatly ensured patient safety.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of nail lichen planus with tofacitinib: a case report and review of the literature

Huang,

Shi

2023

Front. Med.

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Nail lichen planus (NLP) is a chronic inflammatory disease of unknown etiology and has been recognized as a nail potentially critical disorder, which can be severe and rapidly worsen with irreversible scarring. Currently, the treatment options are limited based on disease progression. High-potency topical or intralesional corticosteroids are commonly considered first-line therapeutic options; however, these therapies are unsuitable for all patients with NLP, especially those with extensive lesions. As a potential therapeutic target for inflammatory skin diseases, Janus kinase (JAK) inhibitors can suppress both type-1 and type-2 cytokines, thereby reducing the immune response and resultant inflammation. Recent studies have suggested benefit in cutaneous lichen planus and lichen planopilaris with oral JAK inhibitors. Here, we report a case of severe NLP that exhibited a favorable response to tofacitinib treatment. A 41-year-old woman presented to our clinic with a 2-year history of nail dystrophy of all fingers of both hands. The NLP was finally confirmed by histopathology and the above clinical features. After the informed consent signature, tofacitinib monotherapy, 5 mg twice a day, was then begun, and after 6 months, the appearance of her nails had a significant improvement.

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Section: Discussionmentioning

confidence: 99%

Successful treatment of nail lichen planus with tofacitinib: a case report and review of the literature

Huang,

Shi

2023

Front. Med.

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“…Other JAK inhibitors were used off‐label in alopecia areata, including tofacitinib (JAK 1/3 inhibitor) at a dose of 2 × 5 mg/day, ruxolitinib (JAK 1/2 inhibitor) at a dose of 2 × 20 mg/day, upadacitinib (JAK 1 inhibitor) at a dose of 30 mg/day as well as delgocitinib (JAK 1‐3/TYK2) in Japan at a dose of 30 mg/day. Brepocitinib at a dose of 30–60 mg/day (TYK2/JAK1 inhibitor), deuruxolitinib at a dose of 2 × 8 mg/day are at various pre‐approval stages of drug development for alopecia areata 38,39 …”

Section: Therapeutic Managementmentioning

confidence: 99%

European expert consensus statement on the systemic treatment of alopecia areata

Rudnicka,

Arenbergerova,

Grimalt

et al. 2024

Acad Dermatol Venereol

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Alopecia areata is an autoimmune form of non‐scarring hair loss. It is usually characterized by limited areas of hair loss. However, the disease may progress to complete scalp and body hair loss (alopecia totalis, alopecia universalis). In patients with alopecia areata hair loss significantly impacts the quality of life. Children and adolescents with alopecia areata often experience bullying, including physical aggression. The disease severity evaluation tools used in clinical practice are: the Severity of Alopecia Tool (SALT) score and the Alopecia Areata Scale (AAS). A SALT score equal to or greater than 20 constitutes a commonly accepted indication for systemic therapy in alopecia areata. When using the AAS, moderate to severe alopecia areata should be considered a medical indication for systemic treatment. Currently, the only two EMA‐approved medications for alopecia areata are baricitinib (JAK 1/2 inhibitor) for adults and ritlecitinib (JAK 3/TEC inhibitor) for individuals aged 12 and older. Both are EMA‐approved for patients with severe alopecia areata. Other systemic medications used off‐label in alopecia areata include glucocorticosteroids, cyclosporine, methotrexate and azathioprine. Oral minoxidil is considered an adjuvant therapy with limited data confirming its possible efficacy. This consensus statement is to outline a systemic treatment algorithm for alopecia areata, indications for systemic treatment, available therapeutic options, their efficacy and safety, as well as the duration of the therapy.

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Topical immunotherapy with diphenylcyclopropenone in paediatric patients with alopecia areata—A retrospective study of 97 patients

Esmaeili,

Vahabi,

Abdoli

et al. 2024

Skin Health and Disease

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BackgroundAlopecia areata (AA) is an autoimmune disease causing chronic non‐scarring hair loss. Different therapeutic regimens have been suggested for AA, which depend on patients' age, scalp involvement extent and duration. Topical immunotherapy with diphenylcyclopropenone (DPCP) is one of the treatment options for these patients.ObjectivesWe aimed to investigate the response to DPCP in paediatric AA patients.MethodsThis retrospective study included 97 paediatric AA patients followed in the DPCP clinic from March 2016 to March 2021 at a referral dermatology hospital.ResultsIn a cohort of 97 paediatric patients with AA under treatment with DPCP, with a mean age of 11.10 ± 0.9, 53.6% of the patients were male. Patchy alopecia was the most prevalent type (45.4%). After 6 months of DPCP treatment, 51.5% showed no response, while 3.1% achieved complete response. At the 12‐month evaluation, among the 68 patients who continued treatment, complete response was observed in 8.8%. A significant positive correlation was found between alopecia type, specifically patchy, and treatment response (p = 0.031). Additionally, treatment duration emerged as a significant predictor of positive response at both six (OR 1.450, p = 0.026) and 12 months (OR 1.310, p = 0.043). A higher initial Severity of Alopecia Tool score was inversely correlated with treatment response (Spearman's rho −0.14, p = 0.002), indicating that initial disease severity may predict treatment efficacy.ConclusionsOne year after the onset of DPCP in paediatric AA patients, the complete response and any hair regrowth rates were 8.8% and 61.8%, respectively. The milder initial disease severity and longer duration of treatment resulted in a better response.

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The evaluation of JAK inhibitors on effect and safety in alopecia areata: a systematic review and meta-analysis of 2018 patients

Cited by 7 publications

References 55 publications

Successful treatment of nail lichen planus with tofacitinib: a case report and review of the literature

Successful treatment of nail lichen planus with tofacitinib: a case report and review of the literature

European expert consensus statement on the systemic treatment of alopecia areata

Topical immunotherapy with diphenylcyclopropenone in paediatric patients with alopecia areata—A retrospective study of 97 patients

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