Efficacy of Janus kinase inhibitors in adult patients with alopecia areata

Authors

  • Andrea Sierra Franco Hospital General Regional #45 IMSS, Guadalajara, Jalisco, México
  • Paulina García De León Flores Universidad Autonoma de Guadalajara, Guadalajara, Jalisco, México
  • Paola Scarlett Díaz De Alba Hospital General Regional #46 IMSS, Guadalajara, Jalisco, México
  • María Jimena Talamante Madrid Hospital General de Zona #2 IMSS, Hermosillo, Sonora, México
  • Cassandra Espinosa Rodríguez Hospital General de Zona #2 IMSS, Hermosillo, Sonora, México
  • Renata Monserrat Espejo Nuño Universidad Autonoma de Guadalajara, Guadalajara, Jalisco, México

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20232552

Keywords:

AA, Hair loss, JAKis

Abstract

Alopecia areata (AA) is a chronic, immune-mediated disorder resulting in localized hair loss due to targeting hair follicle epithelium. The authors aimed to summarize the existing literature on patients with AA who underwent treatment with Janus kinase inhibitors (JAKis) and discuss the current evidence regarding their efficacy and safety. An extensive scientific literature search was conducted between January 1, 2017, and April 16, 2023, using a recognized medical and scientific database. The extracted data were synthesized and analyzed, focusing on the effect of JAKis in reducing hair loss in adult patients with AA. The evidence suggests that oral JAKis such as tofacitinib, ruxolitinib, and Baricitinib show promise in treating AA regarding both efficacy and safety. The group of drugs JAKis are a good treatment option even in severe clinical conditions of AA, further investigation should be taken to consideration including dosage and treatment duration.

Metrics

Metrics Loading ...

References

Lee HH, Gwillim E, Patel KR, Hua T, Rastogi S, Ibler E et al. Epidemiology of Alopecia Areata, ophiasis, totalis, and universalis: A systematic review and meta-analysis. J Am Acad Dermatol. 2020;82(3):675-82.

Harries M, Macbeth AE, Holmes S, Chiu WS, Gallardo WR, Nijher M et al. The epidemiology of Alopecia Areata: a population-based cohort study in UK primary care. Br J Dermatol. 2022;186(2):257-65.

Sy N, Mastacouris N, Strunk A, Garg A. Overall and Racial and Ethnic Subgroup Prevalences of Alopecia Areata, Alopecia Totalis, and Alopecia Universalis. JAMA Dermatol. 2023;159(4):419-23.

Afford R, Leung AKC, Lam JM. Pediatric Alopecia Areata. Curr Pediatr Rev. 2021;17(1):45-54.

Yousaf A, Lee J, Fang W, Kolodney MS. Notice of Retraction. Yousaf A et al. Association Between Alopecia Areata and Natural Hair Color Among White Individuals. JAMA Dermatol. 2021;157(8):1007-8.

Dillon KAL. A Comprehensive Literature Review of JAK Inhibitors in Treatment of Alopecia Areata. Clin Cosmet Investig Dermatol. 2021;14:691-714.

Yan D, Fan H, Chen M, Xia L, Wang S, Dong W et al. The efficacy and safety of JAK inhibitors for Alopecia Areata: A systematic review and meta-analysis of prospective studies. Front Pharmacol. 2022;13:950450.

Phan K, Sebaratnam DF. JAK inhibitors for Alopecia Areata: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol JEADV. 2019;33(5):850-6.

Phan K, Sebaratnam DF. JAK inhibitors for Alopecia Areata: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol JEADV. 2019;33(5):850-6.

Yan D, Fan H, Chen M, Xia L, Wang S, Dong W et al. The efficacy and safety of JAK inhibitors for Alopecia Areata: A systematic review and meta-analysis of prospective studies. Front Pharmacol. 2022;13:950450.

Dillon KAL. A Comprehensive Literature Review of JAK Inhibitors in Treatment of Alopecia Areata. Clin Cosmet Investig Dermatol. 2021;14:691-714.

Crowley EL, Fine SC, Katipunan KK, Gooderham MJ. The Use of Janus Kinase Inhibitors in Alopecia Areata: A Review of the Literature. J Cutan Med Surg. 2019;23(3):289-97.

Bansal A, Relhan V, Garg VK, Saran RK. A cross-sectional study of the histopathology and immunology of Alopecia Areata: Unearthing the role of the Janus kinase-signal transducer and activator of transcription pathway. Indian J Dermatol Venereol Leprol. 2019;85(5):455-61.

Chen Y, Zhu H, Shen Y, Zhu Y, Sun J, Dai Y et al. Efficacy and safety of JAK inhibitors in the treatment of Alopecia Areata in children: a systematic review and meta-analysis. J Dermatol Treat. 2022;33(8):3143-9.

Almutairi N, Nour TM, Hussain NH. Janus Kinase Inhibitors for the Treatment of Severe Alopecia Areata: An Open-Label Comparative Study. Dermatol Basel Switz. 2019;235(2):130-6.

Wei D, Chen Y, Shen Y, Xie B, Song X. Efficacy and safety of different JAK inhibitors in the treatment of Alopecia Areata: a network meta-analysis. Front Immunol. 2023;14:1152513.

Yu DA, Kim YE, Kwon O, Park H. Treatment outcome of oral tofacitinib and ruxolitinib in patients with Alopecia Areata: A systematic review and meta-analysis. Indian J Dermatol Venereol Leprol. 2021;87(5):621-7.

King B, Mostaghimi A, Shimomura Y, Zlotogorski A, Choi GS, Blume-Peytavi U et al. Integrated safety analysis of baricitinib in adults with severe Alopecia Areata from two randomized clinical trials. Br J Dermatol. 2023;188(2):218-27.

Hosking AM, Juhasz M, Mesinkovska NA. Topical Janus kinase inhibitors: A review of applications in dermatology. J Am Acad Dermatol. 2018;79(3):535-44.

Strand V. Patient-reported outcomes and realistic clinical endpoints for JAK inhibitors in rheumatoid arthritis. Expert Rev Clin Immunol. 2022;18(3):193-205.

Maqsood MH, Weber BN, Haberman RH, Lo Sicco KI, Bangalore S, Garshick MS. Cardiovascular and Venous Thromboembolic Risk with Janus Kinase Inhibitors in Immune-Mediated Inflammatory Diseases: A Systematic Review and Meta-Analysis of Randomized Trials. ACR Open Rheumatol. 2022;4(10):912-22.

Husein-El Ahmed H, Abdulla N, Al-Obaidli A, Ali-Alam M, Steinhoff M. Real-world experience and long-term evaluation of tofacitinib in refractory Alopecia Areata: A prospective, open-label, single-center study in Asian Arab population. Dermatol Ther. 2022;35(12):e15871.

Dincer Rota D, Emeksiz MAC, Erdogan FG, Yildirim D. Experience with oral tofacitinib in severe Alopecia Areata with different clinical responses. J Cosmet Dermatol. 2021;20(9):3026-33.

Liu LY, Craiglow BG, Dai F, King BA. Tofacitinib for the treatment of severe Alopecia Areata and variants: A study of 90 patients. J Am Acad Dermatol. 2017;76(1):22-8.

Guo L, Feng S, Sun B, Jiang X, Liu Y. Benefit and risk profile of tofacitinib for the treatment of Alopecia Areata: a systemic review and meta-analysis. J Eur Acad Dermatol Venereol JEADV. 2020;34(1):192-201.

Bandeira A, Albino-Teixeira A, Magina S. Systematic review-Alopecia Areata and tofacitinib in pediatric patients. Cutan Ocul Toxicol. 2022;41(2):194-201.

Mahmoud AM. Effectiveness and safety of baricitinib in patients with Alopecia Areata: a systematic review and Meta-analysis of randomized controlled trials. Curr Med Res Opin. 2023;39(2):249-57.

King B, Ko J, Forman S, Ohyama M, Mesinkovska N, Yu G et al. Efficacy and safety of the oral Janus kinase inhibitor baricitinib in the treatment of adults with Alopecia Areata: Phase 2 results from a randomized controlled study. J Am Acad Dermatol. 2021;85(4):847-53.

Kwon O, Senna MM, Sinclair R, Ito T, Dutronc Y, Lin CY et al. Efficacy and Safety of Baricitinib in Patients with Severe Alopecia Areata over 52 Weeks of Continuous Therapy in Two Phase III Trials (BRAVE-AA1 and BRAVE-AA2). Am J Clin Dermatol. 2023;24(3):443-51.

King B, Ohyama M, Kwon O, Zlotogorski A, Ko J, Mesinkovska NA et al. Two Phase 3 Trials of Baricitinib for Alopecia Areata. N Engl J Med. 2022;386(18):1687-99.

Bokhari L, Sinclair R. Treatment of alopecia universalis with topical Janus kinase inhibitors - a double-blind, placebo, and active-controlled pilot study. Int J Dermatol. 2018;57(12):1464-70.

Shin JW, Huh CH, Kim MW, Lee JS, Kwon O, Cho S et al. Comparison of the Treatment Outcome of Oral Tofacitinib with Other Conventional Therapies in Refractory Alopecia Totalis and Universalis: A Retrospective Study. Acta Derm Venereol. 2019;99(1):41-6.

Shivanna CB, Shenoy C, Priya RA. Tofacitinib (Selective Janus Kinase Inhibitor 1 and 3): A Promising Therapy for the Treatment of Alopecia Areata: A Case Report of 6 Patients. Int J Trichol. 2018;10(3):103-7.

Chen Y, Zhu H, Shen Y, Zhu Y, Sun J, Dai Y et al. Efficacy and safety of JAK inhibitors in the treatment of Alopecia Areata in children: a systematic review and meta-analysis. J Dermatol Treat. 2022;33(8):3143-9.

Sechi A, Song J, Dell’Antonia M, Heidemeyer K, Piraccini BM, Starace M et al. Adverse events in patients treated with JAK-inhibitors for Alopecia Areata: A systematic review. J Eur Acad Dermatol Venereol JEADV. 2023;4.

De Oliveira AB, Alpalhão M, Filipe P, Maia-Silva J. The role of Janus kinase inhibitors in the treatment of Alopecia Areata: A systematic review. Dermatol Ther. 2019;32(5):e13053.

Almutairi N, Nour TM, Hussain NH. Janus Kinase Inhibitors for the Treatment of Severe Alopecia Areata: An Open-Label Comparative Study. Dermatol Basel Switz. 2019;235(2):130-6.

Barati Sedeh F, Michaelsdóttir TE, Henning MAS, Jemec GBE, Ibler KS. Comparative Efficacy and Safety of Janus Kinase Inhibitors Used in Alopecia Areata: A Systematic Review and Meta-analysis. Acta Derm Venereol. 2023;103:adv00855.

Downloads

Published

2023-08-24

Issue

Section

Review Articles