Apalla Zoe, Zafiriou Efterpi, Zagkliverinou Effimia, Roussaki-Schulze Angeliki-Viktoria, Gidarokosta Polyxeni, Ntavari Niki, Sakellaropoulou Stella, Boziou Maria, Emvalomati Anastasia, Kyrmanidou Eirini, Lazaridou Elizabeth
Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Department of Dermatology, University General Hospital Larissa, University of Thessaly, Larissa, Greece.
Dermatol Pract Concept. 2024 Apr 1;14(2):e2024073. doi: 10.5826/dpc.1402a73.
The introduction of Janus Kinase inhibitors (JAKi) seems to revolutionize the field of alopecia areata (AA) therapeutics. However, real-world data are still missing.
To provide evidence about effectiveness and safety of tofacitinib and baricitinib in AA in real-world settings and describe baseline disease characteristics and patients profiles that are considered good candidates for JAKi in the daily practice. Furthermore, we intended to investigate potential correlations between baseline characteristics and treatment outcomes.
We retrospectively reviewed the databases of two tertiary Hospitals in Greece, to identify individuals of any age currently being treated with systemic JAKi for severe AA.
We identified 42 individuals, including 3 adolescents. In our cohort, 52.3% (22/42) were under tofacitinib and 47.6% (20/42) under baricitinib treatment. Efficacy analysis was performed on the subgroup of 30 patients that had completed at least a 3-month follow-up on treatment. In the latter group, mean time on treatment was 10 months. Mean Severity of Alopecia Tool and mean Dermatology Life Quality Index scores decreased from 84.46% and 12.86 at baseline, to 43.26% and 6.63, respectively. Complete response (CR) was recorded in 4 (13.33%), partial in 12 (40%) and no response in 14 patients (46.66%), correspondingly. Seventeen out of 42 (40.5%) individuals in total, reported at least 1 adverse event. No patient required hospitalization. Among 15 patients (35.7%) who got COVID-19, one suffered from serious infection. The 3 adolescents achieved CR with no significant adverse events.
Real-world data suggest efficacy and safety of JAKi in severe forms of AA. Tolerability is optimal in younger individuals.
Janus激酶抑制剂（JAKi）的引入似乎给斑秃（AA）治疗领域带来了变革。然而，真实世界的数据仍然缺失。
提供托法替布和巴瑞替尼在真实世界中治疗AA的有效性和安全性证据，并描述在日常实践中被认为是JAKi良好候选者的基线疾病特征和患者概况。此外，我们旨在研究基线特征与治疗结果之间的潜在相关性。
我们回顾性分析了希腊两家三级医院的数据库，以确定目前正在接受系统性JAKi治疗严重AA的任何年龄个体。
我们确定了42名个体，其中包括3名青少年。在我们的队列中，52.3%（22/42）接受托法替布治疗，47.6%（20/42）接受巴瑞替尼治疗。对至少接受了3个月治疗随访的30名患者亚组进行了疗效分析。在后者组中，平均治疗时间为10个月。平均脱发严重程度工具评分和平均皮肤病生活质量指数评分分别从基线时的84.46%和12.86降至43.26%和6.63。相应地，记录到完全缓解（CR）4例（13.33%），部分缓解12例（40%），无反应14例（46.66%）。42名个体中有17名（40.5%）总共报告了至少1次不良事件。没有患者需要住院治疗。在15名（35.7%）感染COVID-19的患者中，1人患有严重感染。3名青少年实现了CR，且无明显不良事件。
真实世界数据表明JAKi在严重形式的AA中具有有效性和安全性。年轻个体的耐受性最佳。
