New Delhi: Tofacitinib, a drug commonly used to treat rheumatoid arthritis and ankylosing spondylitis, has shown excellent results in treatment of an autoimmune disorder, alopecia areata (AA) — sudden hair loss that starts with one or more circular bald patches, reveals a study.
Published last week in an online journal, Indian Dermatology, the study stated that 94.1 per cent of the alopecia areata patients covered showed complete/near complete response with this medicine. At least 23.5 per cent achieved complete hair growth on tofacitinib monotherapy in eight months and maintained it on 5mg alternate day without any relapse. The mean age of patients was 17.6 years, and ranged from 5 to 34 years, with a male-to-female ratio of 8:1.
The lead author of the study, Dr Kabir Sardana of the dermatology department of RML Hospital, said tofacitinib was found to be safe and effective in severe cases of alopecia areata along with alopecia universalis (AU), complete hair loss on your scalp and body, and for alopecia totalis (AT), complete hair loss on the scalp, patients recalcitrant to other treatment modalities. However, the drug has shown poor results in patients suffering for more than 10 years or if it has appeared in the first threeyears of their life.
“It’s a remarkably safe drug. Side effects have been seen only in elderly people and those with heart issues,” he said, adding that auto immune disorders tend to recur so one needs to take it as and when needed. The other option was oral steroids, which have many more side effects and are widely abused.
The primary aim of the study was to assess the complete response rates to tofacitinib monotherapy in severe and recalcitrant AA, AT and AU patients using the latest percentage change in severity of alopecia tool (SALT) score, commonly used for quantifying the amount of scalp hair loss in clinical trials. “The secondary aim was to analyse various systemic agents used by these patients prior to the use of tofacitinib,” said authors.
They said the institutional records of 17 patients with severe or refractory AA, AT, and AU treated with tofacitinib monotherapy were analysed, retrospectively. The response to the therapy was determined after calculating the percentage change in SALT scores.
According to the study, nine of the 17 patients had severe AA, while five patients had AT and three had AU. All patients had earlier received either systemic glucocorticoids, which included oral mini pulse, intravenous pulse steroids and daily oral GCS or immunosuppressive agents. The mean SALT score prior to starting tofacitinib was 74.23.
The mean dose of tofacitinib was 13.23mg (10-15mg) for the mean duration of 9.2 months. The latest percentage change of SALT score ranged from 70.6 per cent to 100 per cent, with an average of 91.5 per cent. The study stated that furtherresearch was needed to assess the long-term efficacy of tofacitinib.