Huang Jundong, Tan Zixin, Tang Yan, Shi Wei
Department of Dermatology, Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China.
Front Med (Lausanne). 2023 Oct 18;10:1287139. doi: 10.3389/fmed.2023.1287139. eCollection 2023.
Although there is growing evidence supporting the effectiveness of Janus kinase (JAK) inhibitors in treating alopecia areata, the high rate of recurrence following drug discontinuation has led to prolonged treatment courses and raised concerns about long-term safety. In clinical practice, caution should be exercised while using JAK inhibitors for various indications, and a comprehensive pre-treatment screening.
This study presents an analysis of screening data collected from real-world settings before the initiation of Janus kinase inhibitors in patients with alopecia areata. Investigators collected retrospective medical data characterizing patients' screening data. Data on demographic and clinical data, including age, sex, disease duration, severity of alopecia tool scale, history of prior treatment, and treatment regimen were recorded.
In this cohort ( = 218), JAK inhibitors were initiated for 163 of 218 (74.8%) alopecia areata patients. The numbers of patients positive for antinuclear antibodies, hepatitis B surface antigen, hepatitis C virus antibodies, human immunodeficiency virus antibody, treponema pallidum hemagglutination assay, and thyroid-stimulating hormone were 32 (32/176), 10(10/218), 0 (0/218), 0 (0/218), 3 (3/218) and 9 (9/176), respectively. The number of patients with T-cell spot positive or imaging of the chest indicating tuberculosis was 37 (37/218).
Our data provide additional information on the safety profile of JAK inhibitors in patients with alopecia areata. As such, it is necessary and crucial to screen for JAK inhibitors before it is used, particularly for individuals with a high risk of tuberculosis, hepatitis B, and other infections.
尽管越来越多的证据支持 Janus 激酶（JAK）抑制剂治疗斑秃的有效性，但停药后高复发率导致治疗疗程延长，并引发了对长期安全性的担忧。在临床实践中，使用 JAK 抑制剂治疗各种适应症时应谨慎，并进行全面的治疗前筛查。
本研究对斑秃患者开始使用 Janus 激酶抑制剂之前从实际临床环境中收集的筛查数据进行了分析。研究人员收集了回顾性医疗数据，以描述患者的筛查数据。记录了人口统计学和临床数据，包括年龄、性别、病程、斑秃工具量表严重程度、既往治疗史和治疗方案。
在该队列（n = 218）中，218 例斑秃患者中有 163 例（74.8%）开始使用 JAK 抑制剂。抗核抗体、乙型肝炎表面抗原、丙型肝炎病毒抗体、人类免疫缺陷病毒抗体、梅毒螺旋体血凝试验和促甲状腺激素检测呈阳性的患者数量分别为 32 例（32/176）、10 例（10/218）、0 例（0/218）、0 例（0/218）、3 例（3/218）和 9 例（9/176）。T 细胞斑点试验阳性或胸部影像学提示结核的患者有 37 例（37/218）。
我们的数据为斑秃患者使用 JAK 抑制剂的安全性概况提供了更多信息。因此，在使用 JAK 抑制剂之前进行筛查是必要且至关重要的，特别是对于结核病、乙型肝炎和其他感染高风险的个体。
