Topical Janus kinase (JAK) inhibitors could be developed as a potential new treatment for alopecia areata (AA) and alternative to clobetasol dipropionate 0.05% ointment, according to the findings of a study published in the International Journal of Dermatology.
Oral Janus kinase (JAK) inhibitors are currently being investigated in phase II and phase III clinical trials for several inflammatory skin diseases including alopecia areata (AA). Topical JAK inhibitors have been investigated in atopic dermatitis, psoriasis, and AA. While a number of case series using topical JAK inhibitors in AA have been published, to date there have been no randomized controlled clinical trials.
Laita Bokhari and associates conducted a phase I, 28-week prospective, placebo‐controlled, double‐blind study in patients with alopecia universalis investigating hair regrowth with two topical JAK inhibitors, 2% tofacitinib and 1% ruxolitinib.
The investigators included sixteen study participants. Topical clobetasol dipropionate 0.005% was the active comparator while the vehicle was used as the placebo control.
The study found six patients demonstrated partial hair regrowth in areas treated with 2% tofacitinib ointment applied twice daily. Five patients demonstrated partial hair regrowth in the areas treated with 1% ruxolitinib ointment. Ten patients demonstrated partial hair regrowth in the areas treated with clobetasol dipropionate 0.05% ointment. No regrowth was observed in the placebo-treated area.
It was interesting to observe that generalized hair regrowth was observed in two patients. One patient had 100% regrowth over his entire scalp and eyebrows by week 24 but relapsed after 12 weeks. A second patient also experienced generalized scalp regrowth and significant eyebrow growth and continued to maintain growth 14 weeks later.
The study concluded that activation of the JAK/STAT pathway has been implicated in alopecia areata (AA), and systemic JAK inhibitors have been shown to improve AA symptoms.
The researchers warrant the need for further studies including the ones testing higher concentrations of drugs to prove their effectiveness.
For full information log on to https://doi.org/10.1111/ijd.14192