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Xeljanz shows promise as treatment for alopecia areata in adolescents
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Treatment with Xeljanz in adolescents with alopecia areata resulted in significant hair regrowth for the majority of the patients, with mild adverse events, according to recently published study results.
Brent A. King, MD, PhD, assistant professor of dermatology, Yale School of Medicine, and colleagues studied 13 adolescent patients (median age 15 years; 77% male) with alopecia areata treated with Xeljanz (tofacitinib, Pfizer) between July 2014 and May 2016 at a tertiary care center clinic.
They used the Severity of Alopecia Tool (SALT) to measure severity of disease, and laboratory monitoring, physical examinations and review of systems to measure adverse events.
The patients were treated for a median duration of 5 months. Patient age ranged from 12 to 17 years at time of treatment initiation. Six patients had alopecia universalis, one had alopecia totalis and six had alopecia areata. The median duration of disease before beginning therapy of 8 years.
All patients received tofacitinib 5 mg twice daily. One patient who had complete regrowth over 5 months developed four 1- to 3-cm patches of alopecia, and received an increased dose of 10 mg in the morning and 5 mg in the evening, with full regrowth occurring again.
Clinically significant hair growth was experienced by nine patients, and very minimal hair growth was experienced by three patients. There was a 93% median change in SALT score for all patients (mean 61%; 1%-100%), and an average treatment time of 6.5 months.
Adverse events were mild and included headaches, upper respiratory infections and mild increases in liver transaminase levels.
Small sample size and lack of a control group were among the study limitations, the researchers reported.
“Tofacitinib was well tolerated and associated with hair regrowth in nearly 70% of patients,” the researchers concluded. “Although the sample size was small, the results suggest that tofacitinib is a promising therapeutic option in [alopecia areata] in the adolescent population. There is potential for serious adverse effects with [Janus kinase] inhibitors, including infection and malignancy, therefore, a thorough discussion of risks and benefits is essential before initiating treatment.” – by Bruce Thiel
Disclosure: Craiglow reports no relevant financial disclosures. Please see the full study for a list of other researchers’ relevant financial disclosures.