The role of Janus kinase inhibitors in the treatment of alopecia areata: A systematic review

Dermatol Ther. 2019 Sep;32(5):e13053. doi: 10.1111/dth.13053. Epub 2019 Aug 19.

Abstract

Alopecia areata (AA) is a non-scarring alopecia, which often carries a major impact on patients' quality of life. Currently there is no single approved treatment that effectively induces permanent remission. Recently, the JAK-STAT signaling pathway has emerged as a possible therapeutic target leading to increased interest in the use of Janus kinase (JAK) inhibitors (JAKis) in the treatment of this pathology. This review of the literature summarizes information on patients with AA who underwent treatment with JAKis and discusses the current evidence on the efficacy and safety of its use. A literature search was conducted in different databases to identify clinical trials and case reports published in January 2019. Several clinical studies have shown very promising results in the treatment of AA with oral formulas of JAKis. These agents, however, need chronic administration to maintain response. Topical formulations did not show satisfactory responses. The safety profile of these agents appears to be favorable. Current evidence is promising regarding the efficacy and safety of oral JAKis. However, the data obtained are of low quality, originating predominantly from reports of clinical cases. Further studies are needed to confirm these data and to optimize its long-term efficacy and safety.

Keywords: JAK inhibitors; alopecia areata; baricitinib; ruxolitinib; tofacitinib.

Publication types

  • Systematic Review

MeSH terms

  • Alopecia Areata / drug therapy*
  • Alopecia Areata / genetics
  • Clinical Trials as Topic
  • Female
  • Humans
  • Janus Kinase 1 / drug effects*
  • Janus Kinase 1 / genetics
  • Janus Kinase Inhibitors / administration & dosage*
  • Male
  • Molecular Targeted Therapy
  • Prognosis
  • Signal Transduction / drug effects*
  • Treatment Outcome

Substances

  • Janus Kinase Inhibitors
  • Janus Kinase 1