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他卡西醇治疗寻常型银屑病有效性和安全性的真实世界研究:一项 202 例患者的回顾性队列研究

Real-world effectiveness and safety of tofacitinib for alopecia areata: A retrospective cohort study of 202 patients.

机构信息

Sinclair Dermatology, Melbourne, Victoria, Australia.

St Helens & Knowsley NHS Trust, Prescot, UK.

出版信息

Australas J Dermatol. 2024 Sep;65(6):505-513. doi: 10.1111/ajd.14325. Epub 2024 Jun 3.

DOI:10.1111/ajd.14325
PMID:38831704
Abstract

BACKGROUND

Alopecia areata (AA) is an autoimmune hair loss disorder characterised by collapse of hair follicle immune privilege and mediated by autoreactive CD8+ T lymphocytes and natural killer cells. Treatment is often unsatisfactory. The Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway is implicated in the pathogenesis of AA and Janus Kinase inhibitor (JAKi) medications are promising emerging treatments for AA.

OBJECTIVES

We evaluated the safety and effectiveness of tofacitinib in a real-world setting over 18 months of treatment.

METHODS

A retrospective cohort study of all patients with scalp AA commenced on tofacitinib between 1 November 2016 and 31 May 2019. The primary endpoint was the percent change in Severity of Alopecia Tool (SALT) score at 18 months.

RESULTS

Two hundred and two patients were included. After 18 months of treatment, 55.9%, 42.6% and 29.2% achieved 50%, 75% and 90% reductions in their SALT scores respectively. Increased duration of AA was a negative predictor of hair regrowth. Males and patients with baseline SALT ≥90 were slower to respond to treatment in the first 12 months. One hundred and twenty-four patients and 168 patients received concomitant systemic corticosteroids or low-dose oral minoxidil during tofacitinib therapy respectively. There were no serious adverse events.

CONCLUSION

Tofacitinib was a safe and effective treatment for patients with moderate-to-severe AA. Further randomised controlled studies are needed to establish the optimal treatment regimen.

摘要

背景

斑秃(AA)是一种自身免疫性脱发疾病,其特征是毛囊免疫特权崩溃,由自身反应性 CD8+T 淋巴细胞和自然杀伤细胞介导。治疗往往不尽如人意。Janus 激酶-信号转导和转录激活因子(JAK-STAT)通路与 AA 的发病机制有关,Janus 激酶抑制剂(JAKi)药物是治疗 AA 的有前途的新兴治疗方法。

目的

我们评估了托法替尼在 18 个月治疗期间的真实世界环境中的安全性和有效性。

方法

这是一项回顾性队列研究,纳入了 2016 年 11 月 1 日至 2019 年 5 月 31 日期间开始接受托法替尼治疗的所有头皮 AA 患者。主要终点是 18 个月时严重程度脱发工具(SALT)评分的百分比变化。

结果

共纳入 202 例患者。治疗 18 个月后,分别有 55.9%、42.6%和 29.2%的患者 SALT 评分降低 50%、75%和 90%。AA 持续时间增加是毛发再生的负面预测因子。男性和基线 SALT≥90 的患者在前 12 个月对治疗的反应较慢。124 例患者和 168 例患者在接受托法替尼治疗期间分别接受了同时使用全身皮质类固醇或低剂量口服米诺地尔治疗。没有严重不良事件。

结论

托法替尼是治疗中重度 AA 患者的安全有效药物。需要进一步的随机对照研究来确定最佳治疗方案。

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Real-world effectiveness and safety of tofacitinib for alopecia areata: A retrospective cohort study of 202 patients.他卡西醇治疗寻常型银屑病有效性和安全性的真实世界研究:一项 202 例患者的回顾性队列研究
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Front Immunol. 2025 Sep 1;16:1621492. doi: 10.3389/fimmu.2025.1621492. eCollection 2025.
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Three types of alopecia in one patient: A case of central centrifugal cicatricial alopecia, alopecia areata, and telogen effluvium.一名患者出现三种类型的脱发:中心离心性瘢痕性脱发、斑秃和休止期脱发病例。
JAAD Case Rep. 2025 Jun 30;63:109-111. doi: 10.1016/j.jdcr.2025.06.028. eCollection 2025 Sep.
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Real-world Effectiveness and Safety of Janus Kinase Inhibitors in Alopecia Areata: A Retrospective Cohort Study of 72 Patients.
斑秃患者中JAK抑制剂的真实世界有效性和安全性:一项对72例患者的回顾性队列研究
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