Alopecia areata and tofacitinib: a prospective multicenter study from a Saudi population

• Published in: International journal of dermatology Vol. 61; no. 7; pp. 886 - 894
• Main Authors: AlMarzoug, Alanoud, AlOrainy, May, AlTawil, Lama, AlHayaza, Ghada, AlAnazi, Rasha, AlIssa, Ahmed, AlSheikh, Afaf, AlKhalifah, Abdullah, AlHarithy, Ruaa
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-07-2022
• Subjects: Alopecia; Alopecia - drug therapy; Alopecia Areata - drug therapy; Autoimmune diseases; Baldness; Enzyme inhibitors; Hair; Hair loss; Health care facilities; Humans; Janus kinase; Kinases; Patients; Piperidines; Population studies; Prospective Studies; Pyrimidines; Pyrroles - adverse effects; Regrowth; Salts; Saudi Arabia; Scalp; Steroid hormones; Treatment Outcome; Saudi Arabia
• ISSN: 0011-9059; 1365-4632
• DOI: 10.1111/ijd.15917

Background
Alopecia areata (AA) is an autoimmune disorder characterized by nonscarring hair loss that can involve the scalp, face, and body. Severe AA subtypes have a poorer prognosis and can be challenging to treat. Tofacitinib, a recently introduced Janus kinase inhibitor, has shown positive results in treating AA. This multicenter study demonstrates the efficacy of tofacitinib and the patient response rate in a Saudi population. It also highlights patient characteristics that may serve as predictors of the therapeutic response to tofacitinib.
Methods
A prospective cohort study design was utilized. Study participants were included from three medical centers in Riyadh, Saudi Arabia. The Severity of Alopecia Tool (SALT) score was used to assess the percentage of hair loss at baseline and the percentage of hair regrowth at 3 and 6 months.
Results
The sample size was 68 with an average baseline SALT score of 76.8 ± 27.6%. Data at 6 months were available for 45 patients. Of these, 62.2% achieved a SALT score of >50%. Patients with a score of <50% had a significantly higher baseline SALT score compared to patients with >50% score. The past use of systemic steroids was associated with a diminished response to therapy (P = 0.015). The response to therapy was significantly higher in patients with AA compared to alopecia totalis and alopecia universalis.
Conclusions
Tofacitinib is an effective and well‐tolerated treatment for severe AA and exhibits a good safety profile.