A comment on JAK inhibitors for treatment of alopecia areata

Trüeb, Ralph M.; Dutra, Hudson; Dias, Maria Fernanda Reis Gavazzoni

doi:10.4103/ijt.ijt_62_18

Cited by 7 publications

(9 citation statements)

References 32 publications

(34 reference statements)

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“…Many case reports and limited clinical studies demonstrated impressive therapeutic effects of JAK inhibitors in patients with AA. 57,115,116 In current practice various JAK/signal transducer and activator of transcription (STAT) inhibitors are probably the most effective new pharmacologic intervention strategies currently under development (Fig 1, A). However, concerns still exist regarding unknown long-term side effects with these medications.…”

Section: Novel Therapeutic Intervention Strategiesmentioning

confidence: 99%

“…Given their promise as effective novel AA therapeutics, 58,59,115 it is perfectly understandable that most investigators in both academia and industry currently seem to focus on JAK/STAT inhibitors. These inhibitors block signaling through a broad range of receptors that use the JAK/STAT pathway and do not really provide new insight into the pathogenesis of AA.…”

Section: Final Perspectivesmentioning

confidence: 99%

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Frontiers in alopecia areata pathobiology research

Gilhar

Laufer-Britva

Keren

et al. 2019

Journal of Allergy and Clinical Immunology

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This current review explores selected and as yet insufficiently investigated frontiers in current alopecia areata (AA) pathobiology research, with an emphasis on potential ''new'' players in AA pathobiology that deserve more systematic exploration and therapeutic targeting. Indeed, new evidence suggests that CD8 1 T cells, which have long been thought to be the central players in AA pathobiology, are not the only drivers of disease. Instead, subsets of natural killer (NK) and so-called ''unconventional'' T cells (invariant NK T cells, gd T cells, classic NK cells, and type 1 innate lymphoid cells), all of which can produce large amounts of IFN-g, might also drive AA pathobiology independent of classical, autoantigen-dependent CD8 1 T-cell functions. Another important new frontier is the role of regulatory lymphocyte subsets, such as regulatory T cells, gd regulatory T cells, NKT10 cells, and perifollicular mast cells, in maintaining physiologic hair follicle immune privilege (IP); the extent to which these functions are defective in patients with AA; and how this IP-protective role could be restored therapeutically in patients with established AA. Broadening our AA research horizon along the lines suggested above promises not only to open the door to innovative and even more effective immunotherapy strategies for AA but will also likely be relevant for other autoimmune disorders in which pathobiology, ectopic MHC class I expression, and IP collapse play an important role.

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Section: Novel Therapeutic Intervention Strategiesmentioning

confidence: 99%

Section: Final Perspectivesmentioning

confidence: 99%

Frontiers in alopecia areata pathobiology research

Gilhar

Laufer-Britva

Keren

et al. 2019

Journal of Allergy and Clinical Immunology

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“…Although AA has been described as a benign, self-limiting condition with most cases resulting in spontaneous regrowth, this regrowth may take place over a period of several months to years, with approximately 66% of patients showing complete regrowth of hair within 5 years. 4 However, relapse is common in AA, and studies have reported that in patients observed over a period of 10–20 years that the overall incidence rate of relapses ranges from 85–100%, with 100% relapse being observed in patients over a 20-year period. 4 For patients who progress to the more severe forms of AT and AU, 75% will remain with AT and 34% of adults (44% children) would experience periods of hair growth with AU.…”

Section: Introduction/ Backgroundmentioning

confidence: 99%

“… 4 However, relapse is common in AA, and studies have reported that in patients observed over a period of 10–20 years that the overall incidence rate of relapses ranges from 85–100%, with 100% relapse being observed in patients over a 20-year period. 4 For patients who progress to the more severe forms of AT and AU, 75% will remain with AT and 34% of adults (44% children) would experience periods of hair growth with AU. 4 From this, it is clear that patients may experience many difficulties while dealing with this disease.…”

Section: Introduction/ Backgroundmentioning

confidence: 99%

“… 4 For patients who progress to the more severe forms of AT and AU, 75% will remain with AT and 34% of adults (44% children) would experience periods of hair growth with AU. 4 From this, it is clear that patients may experience many difficulties while dealing with this disease. Affected individuals are at increased risk for emotional and psychological distress, including depression and anxiety.…”

Section: Introduction/ Backgroundmentioning

confidence: 99%

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A Comprehensive Literature Review of JAK Inhibitors in Treatment of Alopecia Areata

Dillon¹

2021

CCID

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Alopecia areata (AA) is a chronic, immune-mediated form of nonscarring alopecia that is multifactorial and results in localized patches. It is often described as a self-limiting condition that results in the spontaneous regrowth of hair in most cases. However, this regrowth may take several months or years to occur in some patients, leading to the development of psychoemotional trauma in those that are affected. Although several therapies for AA have been developed and tested, there is no specific treatment that has been approved, leading to the availability of many off-label conventional treatment options, with very limited responses. More recently, with the advancement of pre-clinical and genetic studies, a greater understanding of the pathomechanisms involved in the development of AA has been uncovered. This has resulted in the introduction of targeted therapies that use small molecules to block specific pathways involved in AA pathophysiology. As such, the use of janus kinase (JAK) inhibitors for treatment of AA has emerged. JAK inhibitors block the T-cell mediated inflammatory response thought to be the driving factor behind AA pathogenesis, by inhibiting the janus kinase (JAK) signal transducer and activator of transcription (STAT) signaling pathway, leading to a reversal of hair loss in AA patients. Thus, in an effort to demonstrate the efficacy of JAK inhibitors in the treatment of AA, several studies have been published within recent years. However, the question remains, “Are JAK inhibitors effective and safe in the management of Alopecia Areata?”. This review aims to provide a comprehensive report on the role, efficacy, and outcomes of using JAK inhibitors in the treatment of AA. To competently answer the research question highlighted, the most recent, quality articles published over a 10–15-year period were sourced using PubMed, NCBI, Research gate, Medline, Cochrane Central Register of Controlled Trials, EMBASE and Google scholar. The literature search was primarily focused on randomized controlled trials (RCTs); however, in the absence of such, only the most recently published case reports, case series, clinical trials and open-label studies published to date were included.

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Update on pulse corticosteroid therapy for the management of alopecia areata

Bernhardt,

Wenzel

2024

JEADV Clinical Practice

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Alopecia areata is a nonlife‐threatening autoimmune disorder and often requires systemic treatment to stop the disease from progressing. Pulse corticosteroid therapy (PCT) is a common way to treat severe alopecia areata although the exact benefit on this treatment remains unclear. The aim of this article is to update current knowledge of hair regrowth rates after PCT. Twenty studies with a total of 2144 patients were reviewed. Eight out of 20 studies allow statements on patients who did not respond at all on PCT. From 680 patients in those eight studies, 211 showed no response, which equals a rate of 31.02%. However, nine out of the 20 studies point out how many patients achieved hair regrowth >50% or a reduction in Severity of Alopecia Areata Tool Score by >50%: 131 patients out of 272 achieved a response with >50% hair regrowth, which corresponds to a rate of 48.16%. Complete regrowth of hair was observed and documented in nine studies: Out of the 1757 patients, 677 showed full regrowth leading to a complete response rate of 38.53%. At University Hospital Bonn, Department of Dermatology, Germany, PCT has been an established treatment for severe alopecia areata over the past decades. Nevertheless, many unwanted side effects were observed. A retrospective study on hair regrowth after PCT was performed in 2022 and is also part of this article. Nineteen studies from literature search through the PubMed database and the one own study led to a total of 20 studies being reviewed in this article.

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A comment on JAK inhibitors for treatment of alopecia areata

Cited by 7 publications

References 32 publications

Frontiers in alopecia areata pathobiology research

Frontiers in alopecia areata pathobiology research

A Comprehensive Literature Review of JAK Inhibitors in Treatment of Alopecia Areata

Update on pulse corticosteroid therapy for the management of alopecia areata

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