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Response to Tofacitinib Therapy of Eyebrows and Eyelashes in Alopecia Areata

While JAK inhibitors have emerged as treatment of alopecia areata, studies have focused on scalp hair growth. In this study, we evaluated the response of eyebrows and eyelashes to tofacitinib.

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Response to Tofacitinib Therapy of Eyebrows and Eyelashes in Alopecia Areata

  1. 1. Response to Tofacitinib Therapy of Eyebrows and Eyelashes in Alopecia Areata Brett King, MD, PhD Associate Professor of Dermatology Yale University School of Medicine
  2. 2. Disclosures I have received honoraria or consulting fees from: Aclaris Therapeutics, Concert Pharmaceuticals, Eli Lilly, Pfizer, Roivant Sciences My wife, Britt Craiglow, has received honoraria and consulting fees from: Pfizer
  3. 3. The clinical course of severe AA is unpredictable and there is little data to guide expectations of disease course, with or without treatment There is involvement of the eyebrows and/or eyelashes in up to 76% of patients with AA JAK inhibitors are efficacious for the treatment of AA, but studies have focused on scalp hair growth What is known
  4. 4. Baseline 2 months tofacitinib 5 mg BID 5 months tofa 10 + 5 mg daily 8 months tofa 10 + 5 mg daily
  5. 5. Aim of study • Evaluate the response of eyebrows and eyelashes in patients with AA treated with the JAK inhibitor, tofacitinib
  6. 6. Methods • Records of all patients treated with tofacitinib and evaluated between January 2014 and April 2018 were identified • Inclusion criteria for this study were: – diagnosis of AA with scalp involvement in addition to eyebrows or eyelashes involvement – 6 months of tofacitinib therapy – treatment responses were documented (absent, partial, or complete).
  7. 7. Methods 119 Total patients 98 (82.4%) Total scalp hair loss 86 (87.8%) + both eyebrows and eyelash involvement 11 (11.2%) + eyebrows involvement only 1 (1.0%) + eyelash involvement only 21 (17.6%) Subtotal scalp hair loss 15 (71.4%) + both eyebrows and eyelash involvement 3 (14.3%) + eyebrows involvement only 3 (14.3%) + eyelash involvement only
  8. 8. Results: Eyebrows Regrowth 34.5% 42.0% 23.5% 14.3% 52.4% 33.3% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Complete Regrowth Partial Regrowth No Regrowth % of regrowth in eyebrows regrowth (total, % of n=119) and with Intralesional triamcinolone (ILK, % of n=21) Eyebrows total Eyebrows ILK
  9. 9. Results: Eyelashes Regrowth 38.7% 30.3% 31.1% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Complete Regrowth Partial Regrowth No Regrowth % of regrowth in eyelashes
  10. 10. Results: Combinations of Regrowth Complete eyebrows and eyelashes and absent scalp growth 1 (0.8%) Complete eyebrows, eyelashes, and partial scalp growth 19 (16.0%) Complete eyebrows, eyelashes and complete scalp growth 19 (16.0%) Partial eyebrows, eyelashes, and scalp growth 43 (36.1%)
  11. 11. Summary • Severe scalp hair loss often predicts eyebrows and/or eyelashes involvement • When there is more than one hair-bearing site involved, all of the hair-bearing sites do not necessarily respond similarly to treatment, i.e. scalp hair may regrow without regrowth of eyebrows and/or eyelashes and vice versa • Although regrowth of scalp hair is uncommon in AA with complete or near-complete scalp hair loss of >10 years duration, eyebrows and eyelashes in these patients may respond (completely) to treatment.
  12. 12. Acknowledgments My patients My nurse: Cara Esposito My wife and collaborator: Britt Craiglow The scientists: Angela Christiano & Raphael Clynes Support: The Ranjini and Ajay Poddar Resource Fund for Dermatologic Diseases Research
  13. 13. Thank you brett.king@yale.edu

While JAK inhibitors have emerged as treatment of alopecia areata, studies have focused on scalp hair growth. In this study, we evaluated the response of eyebrows and eyelashes to tofacitinib.

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