Shanmugam Sujeeth Krishna, Palmer Victoria, McMichael Amy
All authors are with the Department of Dermatology at the Wake Forest University School of Medicine in Winston-Salem, North Carolina.
J Clin Aesthet Dermatol. 2025 Jun;18(6):26-28.
While Janus kinase inhibitors (JAKi) show excellent outcomes in Phase2b/3 trials for alopecia areata (AA), they do have potential side effects due to their immunosuppressive nature and other effects on the JAK-STAT pathway. These side effects can be mitigated by adherence to lab monitoring.
The authors sought to analyze patients, using JAKi, to manage symptoms of AA, to determine frequency of lab monitoring and check for adherence to the recommended rate of every three months.
A retrospective chart review was conducted by first identifying all patients diagnosed with AA at a specialty hair clinic in an academic dermatology department between January 2021 and May 2024. Each patient chart was reviewed for past and current use of any known oral JAKi. Fifty-seven patients were identified to meet our inclusion criteria and all of their charts were reviewed. The primary outcome is the average time between lab monitoring dates for each patient. The hypothesis was formulated after the data collection in the form of whether patients were being adherent to lab monitoring protocol.
Most patients were non-adherent to the lab testing frequency standard. Significant differences were found in blood test times between adherent and non-adherent patients and between non-adherent and extremely non-adherent patients with -values less than 0.01 for both sets.
Patients with AA undergoing JAKi treatment are not adhering to the recommended lab monitoring frequency. New tactics to improve adherence need to be taken.
虽然 Janus 激酶抑制剂(JAKi)在斑秃(AA)的 2b/3 期试验中显示出优异的疗效,但由于其免疫抑制特性以及对 JAK-STAT 通路的其他影响,它们确实存在潜在的副作用。通过坚持实验室监测可以减轻这些副作用。
作者试图分析使用 JAKi 治疗 AA 症状的患者,以确定实验室监测的频率,并检查是否遵守每三个月一次的推荐频率。
通过首先识别 2021 年 1 月至 2024 年 5 月期间在一所学术皮肤科的专科毛发诊所被诊断为 AA 的所有患者,进行回顾性病历审查。审查每个患者的病历,了解过去和当前使用任何已知口服 JAKi 的情况。确定 57 名患者符合纳入标准,并对他们所有的病历进行了审查。主要结果是每个患者两次实验室监测日期之间的平均时间。在数据收集之后,以患者是否遵守实验室监测方案的形式提出假设。
大多数患者未遵守实验室检测频率标准。在坚持和不坚持的患者之间以及不坚持和极度不坚持的患者之间,血液检测时间存在显著差异,两组的 P 值均小于 0.01。
接受 JAKi 治疗的 AA 患者未遵守推荐的实验室监测频率。需要采取新的策略来提高依从性。