Efficacy of tofacitinib in treatment of alopecia universalis in two patients.
BACKGROUND
Autoimmune-triggered non-scarring hair loss is a feature of alopecia areata (AA). Initially patchy and often self-limited, severe hair loss forms include the complete loss of scalp hair or alopecia totalis (AT) and complete loss of all hair or alopecia universalis (AU). For AT and AU a reliable treatment has remained elusive. The targeted kinase inhibitor tofacitinib, in current use for treatment of other immune diseases, has been hypothesized as a viable option for AA, AT and AU therapy and a few case reports support this.


OBJECTIVE
Our study aims to provide evidence for the effectiveness of tofacitinib in the treatment of AU.


METHODS
Two patients diagnosed with long-term AU were prescribed tofacitinib citrate at a dosage of 5 mg twice daily and observed for eight months.


RESULTS
In the first patient, beard growth was significant by 3 months of treatment. By 6 months of treatment, hair growth was apparent throughout the entire body. By 8 months of treatment, scalp hair continued to grow longer and thicker. In addition, eyelashes and eyebrows were established. In the second patient, a noticeable increase in scalp hair was present just 1 month into treatment. By 4 months into treatment, significant scalp regrowth was observed as well as eyelash, eyebrow and beard regrowth. Axillary hair regrowth and isolated leg hair was noted by 8 months.


CONCLUSIONS
In our patients, tofacitinib successfully alleviated AU in the absence of significant adverse side-effects. We recommend that further study be required to establish safety and confirm efficacy.
Department of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada.|Mediprobe Research Inc., London, Ontario, Canada.
A K
AK
Gupta
Mediprobe Research Inc., London, Ontario, Canada.
J L
JL
Carviel
Department of Medicine, Baylor University Medical Center, Dallas, TX, USA.|Departments of Dermatology and Family Practice, University of Texas Southwestern Medical School, Dallas, TX, USA.|Dermatology Treatment and Research Center, Dallas, TX, USA.
W
W
Abramovits
D000328:Adult; D000505:Alopecia / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D008297:Male; D010880:Piperidines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use*; D016896:Treatment Outcome
D010880:Piperidines; D011743:Pyrimidines; D011758:Pyrroles; C479163:tofacitinib