Department of Dermatology, Faculty of Medicine, Ufuk University, Ankara, Turkey.
Department of Dermatology, Silifke State Hospital, Mersin, Turkey.
J Cosmet Dermatol. 2021 Sep;20(9):3026-3033. doi: 10.1111/jocd.13966. Epub 2021 Feb 7.
Alopecia areata (AA) and generalized form, universalis (AU) are common causes of noncicatricial alopecia, targeting anagen hair follicles. A dominant interferon-gamma transcriptional signaling and cytotoxic T lymphocytes were accused as the main drivers of disease pathogenesis. Tofacitinib is a Janus kinase inhibitor that has been proven to interfere with the positive feedback loop between the follicular cell and the cytotoxic T lymphocytes in AA. There is an increasing number of studies reporting success with tofacitinib in AA.
We aimed to assess oral tofacitinib's safety and efficacy in 13 recalcitrant AA and AU patients.
This is a retrospective pilot study performed between 2017 and 2020. The demographic features and the treatment responses were evaluated with Severity of Alopecia Tool score changes.
Thirteen recalcitrant alopecia areata patients (3 AA, 10 AU), aged between 17 and 49, were included in the study. The treatment duration was 3-15 months. All three AA patients responded well; however, the therapy was unsuccessful in five of ten AU patients. Relapse was observed in one of the AA and three of the AU responders. Acneiform lesions and elevation of transaminases were the major side effects.
Tofacitinib seems to be more promising and thriving in the treatment of AA than AU. Starting the therapy earlier can bring more successful results. Unfortunately, even in the cases that fully respond to treatment, relapse can be observed after discontinuation of the treatment. It is essential to inform patients about this situation in reducing the frustrations that may occur later.
斑秃（AA）和广泛性脱发（AU）是常见的非瘢痕性脱发病因，影响生长期毛囊。干扰素-γ转录信号和细胞毒性 T 淋巴细胞被认为是疾病发病机制的主要驱动因素。托法替尼是一种 Janus 激酶抑制剂，已被证明可干扰 AA 中毛囊细胞与细胞毒性 T 淋巴细胞之间的正反馈环。越来越多的研究报告称托法替尼治疗 AA 有效。
我们旨在评估口服托法替尼治疗 13 例难治性 AA 和 AU 患者的安全性和疗效。
这是一项在 2017 年至 2020 年期间进行的回顾性试点研究。采用脱发严重程度工具评分变化评估人口统计学特征和治疗反应。
研究纳入了 13 例难治性斑秃患者（3 例 AA，10 例 AU），年龄在 17 至 49 岁之间。治疗持续时间为 3-15 个月。3 例 AA 患者均有良好反应，但 10 例 AU 患者中 5 例治疗无效。1 例 AA 缓解者和 3 例 AU 缓解者出现复发。痤疮样皮损和转氨升高是主要的副作用。
托法替尼在治疗 AA 方面似乎比 AU 更有前景和疗效。早期开始治疗可以带来更成功的结果。不幸的是，即使在完全对治疗有反应的情况下，停药后也可能观察到复发。告知患者这种情况对于减少以后可能出现的挫折感至关重要。
