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Xeljanz treatment of alopecia areata shows varied efficacy

Xeljanz was a successful treatment for patients with alopecia areata; however, the efficacy varied widely, according to study results recently published in JAMA Dermatology.

Researchers conducted a retrospective medical review between May 1 and June 1, 2016, using Cleveland Clinic medical records to identify 13 patients with alopecia areata who were being treated with Xeljanz (tofacitinib, Pfizer).

Tofacitinib treatment was initiated at 5 mg twice daily, with daily dosage increased by 5 mg per month, as allowable by insurance, until first signs of hair growth were noted by a treating physician. Medication was then held at that dose.

Hair loss validity was determined by the treating physician using the validated Severity of Alopecia Tool (SALT) score.

Patients had a mean pretreatment scalp loss of 93%, including two patients who had alopecia totalis and seven patients with alopecia universalis.

There was a range of regrowth rates, from 2% to 90%, with a mean regrowth rate of 44.3%. A regrowth of at least 50% was achieved by seven patients.

Time of treatment initiation to any sign of hair growth ranged from 1 month to 9 months, with a mean of 4.2 months.

One patient withdrew from treatment after developing morbilliform eruption and peripheral edema. Two patients experienced a shed that led to baseline levels after discountinung treatment at 3 months because of loss of insurance.

The other 11 patients continued treatment. Two patients experiencing lipid and liver abnormalities, which were resolved with dose reduction.

 “Although small, our cohort achieved greater median improvement in SALT scores than reported in previous studies (50.5% vs. 21%),” the researchers wrote. “This outcome may be related to our higher doses, longer duration of therapy, and patients’ shorter duration of current disease episode.”

“Oral tofacitinib is a successful treatment for [alopecia areata] but its efficacy varies widely,” the researchers concluded. “To truly assess efficacy, therapeutic trials should continue in the clinical setting for a minimum of 4 months and potentially up to 1 year.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.