Department of Dermatology, Liverpool Hospital, Sydney, NSW, Australia.
Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
J Eur Acad Dermatol Venereol. 2019 May;33(5):850-856. doi: 10.1111/jdv.15489. Epub 2019 Apr 10.
There have been a number of case reports and small clinical trials reporting promising outcomes of Janus Kinase (JAK) inhibitors tofacitinib, ruxolitinib and baricitinib for alopecia areata (AA). The majority of the literature to date is based on small volume data, with a lack of definitive evidence or guidelines. To determine the expected response of AA to JAK inhibitor therapy and factors which influence response and recurrence rates. A systematic review and meta-analysis was performed according to PRISMA guidelines. From 30 studies and 289 cases, there were 72.4% responders, good responders 45.7% and partial responders 21.4%. Mean time to initial hair growth was 2.2 ± 6.7 months, and time to complete hair regrowth was 6.7 ± 2.2 months. All 37 recurrences occurred when treatment was ceased after 2.7 months. Oral route was significantly associated with response to treatment compared to topical therapy. No difference was found between paediatric and adult cases in proportion of responses. There is promising low-quality evidence regarding the effectiveness of JAK inhibitors in AA. Future large-sized randomized studies are required to confirm findings.
已经有许多病例报告和小型临床试验报告称，Janus 激酶（JAK）抑制剂托法替尼、芦可替尼和巴瑞替尼对斑秃（AA）有较好的疗效。迄今为止，大多数文献都是基于小样本量数据，缺乏明确的证据或指南。为了确定 AA 对 JAK 抑制剂治疗的预期反应以及影响反应和复发率的因素。根据 PRISMA 指南进行了系统评价和荟萃分析。从 30 项研究和 289 例病例中，有 72.4%的患者有反应，其中 45.7%为良好反应，21.4%为部分反应。初始头发再生的平均时间为 2.2±6.7 个月，完全头发再生的时间为 6.7±2.2 个月。所有 37 例复发均发生在治疗停止后 2.7 个月。与局部治疗相比，口服途径与治疗反应显著相关。儿童和成人病例在反应比例方面无差异。JAK 抑制剂治疗 AA 的有效性有低质量的证据支持。需要进行更大规模的随机研究来证实这些发现。
