Journal article
An Open-Label Pilot Study to Evaluate the Efficacy of Tofacitinib in Moderate to Severe Patch-Type Alopecia Areata, Totalis, and Universalis
Journal of investigative dermatology, Vol.138(7), pp.1539-1545
07/2018
DOI: 10.1016/j.jid.2018.01.032
PMCID: PMC6564681
PMID: 29452121
Abstract
Alopecia areata (AA) is a common autoimmune disease with a lifetime risk of ∼2%. In AA, the immune system targets the hair follicle, resulting in clinical hair loss. The prognosis of AA is unpredictable, and currently there is no definitive treatment. Our previous whole genome expression studies identified active immune circuits in AA lesions, including common γ-chain cytokine and IFN pathways. Because these pathways are mediated through JAK kinases, we prioritized clinical exploration of small molecule JAK inhibitors. In preclinical trials in mice, tofacitinib successfully prevented AA development and reversed established disease. In our tofacitinib trial in 12 patients with moderate to severe AA, 11 patients completed a full course of treatment with minimal adverse events. Following limited response to the initial dose (5 mg b.i.d.), the dose was escalated (10 mg b.i.d.) for nonresponding subjects. Eight of 12 patients demonstrated ≥50% hair regrowth, while three patients demonstrated <50% hair regrowth, as measured by Severity in Alopecia Tool scoring. One patient demonstrated no regrowth. Gene expression profiles and Alopecia Areata Disease Activity Index scores correlated with clinical response. Our open-label studies of ruxolitinib and tofacitinib have shown dramatic clinical responses in moderate to severe AA, providing strong rationale for larger clinical trials using JAK inhibitors in AA. ClinicalTrials.gov ID NCT02299297.
Details
- Title: Subtitle
- An Open-Label Pilot Study to Evaluate the Efficacy of Tofacitinib in Moderate to Severe Patch-Type Alopecia Areata, Totalis, and Universalis
- Creators
- A Jabbari - Department of Dermatology, Columbia University, New York, New York, USAF Sansaricq - Department of Dermatology, Columbia University, New York, New York, USAJ Cerise - Department of Dermatology, Columbia University, New York, New York, USAJ.C Chen - Department of Dermatology, Columbia University, New York, New York, USAA Bitterman - Department of Dermatology, Columbia University, New York, New York, USAG Ulerio - Department of Dermatology, Columbia University, New York, New York, USAJ Borbon - Department of Dermatology, Columbia University, New York, New York, USAR Clynes - Department of Dermatology, Columbia University, New York, New York, USAA.M Christiano - Department of Dermatology, Columbia University, New York, New York, USAJ Mackay-Wiggan - Department of Dermatology, Columbia University, New York, New York, USA
- Resource Type
- Journal article
- Publication Details
- Journal of investigative dermatology, Vol.138(7), pp.1539-1545
- DOI
- 10.1016/j.jid.2018.01.032
- PMID
- 29452121
- PMCID
- PMC6564681
- NLM abbreviation
- J Invest Dermatol
- ISSN
- 0022-202X
- eISSN
- 1523-1747
- Publisher
- Elsevier Inc
- Grant note
- name: National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases, award: K08AR0691110; name: Columbia Skin Disease Research Center, award: NIAMS P30AR044535
- Language
- English
- Date published
- 07/2018
- Academic Unit
- Dermatology
- Record Identifier
- 9984025315802771
Metrics
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