Erfolgreiche Therapie einer Alopecia areata partim universalis mit Tofacitinib

Zusammenfassung

Alopecia areata ist eine T-Zell-vermittelte, nicht vernarbende Alopezie, die einen großen Einfluss auf die Lebensqualität der Patienten hat. Derzeit gibt es keine zugelassene Therapie, die eine dauerhafte Remission induziert. Kürzlich hat sich der JAK-STAT-Signalweg als mögliches therapeutisches Ziel herausgestellt, und die Ergebnisse der klinischen Studien mit oralen JAK-Inhibitoren (JAKis) zeigten sich vielversprechend. Wir berichten über einen 29-jährigen Patienten mit Alopecia areata partim universalis, der nach Versagen bisheriger Therapien probatorisch mit dem JAKi Tofacitinib behandelt wurde, worunter es zu einer anhaltenden Remission kam.

Abstract

Alopecia areata is a T-cell-mediated, non-scarring alopecia that has a major impact on patients' quality of life. There is currently no approved therapy that induces permanent remission of the disease. Recently, the JAK-STAT signaling pathway has emerged as a potential therapeutic target and the results of clinical studies with oral JAK inhibitors have shown promising results. We report on a 29-year-old patient with alopecia areata partim universalis who was treated with the JAKi tofacitinib after failure of other treatments, leading to remission of the disease.

Publication History

Article published online:
11 May 2020

• Literatur

• 1 Pratt CH, King LE, Messenger AG. et al. Alopecia areata. Nat Rev Dis Primers 2017; 3: 17011
• 2 Mirzoyev SA, Schrum AG, Davis MDP. et al. Lifetime incidence risk of alopecia areata estimated at 2.1 % by Rochester Epidemiology Project, 1990-2009. J Invest Dermatol 2014; 134: 1141-1142
• 3 Simakou T, Butcher JP, Reid S. et al. Alopecia areata: A multifactorial autoimmune condition. J Autoimmun 2019; 98: 74-85
• 4 Messenger AG, McKillop J, Farrant P. et al. British Association of Dermatologists’ guidelines for the management of alopecia areata 2012. Br J Dermatol 2012; 166: 916-926
• 5 Delamere FM, Sladden MM, Dobbins HM. et al. Interventions for alopecia areata. Cochrane Database Syst Rev 2008; 16: CD004413
• 6 Xing L, Dai Z, Jabbari A. et al. Alopecia areata is driven by cytotoxic T lymphocytes and is reversed by JAK inhibition. Nat Med 2014; 20: 1043-1049
• 7 Guo H, Cheng Y, Shapiro J. et al. The Role of Lymphocytes in the Development and Treatment of Alopecia Areata. Expert Rev Clin Immunol 2015; 11: 1335-1351
• 8 Kennedy Crispin M, Ko JM, Craiglow BG. et al. Safety and efficacy of the JAK inhibitor tofacitinib citrate in patients with alopecia areata. JCI Insight 2016; 1: e89776
• 9 Liu LY, Craiglow BG, Dai F. et al. Tofacitinib for the treatment of severe alopecia areata and variants: A study of 90 patients. J Am Acad Dermatol 2017; 76: 22-28
• 10 Mackay-Wiggan J, Jabbari A, Nguyen N. et al. Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata. JCI Insight 2016; 1: e89790
• 11 de Oliveira AB, Alpalhão M, Filipe P. et al. The role of Janus kinase inhibitors in the treatment of alopecia areata: A systematic review. Dermatologic Therapy 2019; 32: e13053
• 12 Pérez-Jeldres T, Tyler CJ, Boyer JD. et al. Targeting Cytokine Signaling and Lymphocyte Traffic via Small Molecules in Inflammatory Bowel Disease: JAK Inhibitors and S1PR Agonists. Front Pharmacol 2019; 10: 212 https://www.frontiersin.org/articles/10.3389/fphar.2019.00212/full#B52
• 13 Scott IC, Hider SL, Scott DL. Thromboembolism with Janus Kinase (JAK) Inhibitors for Rheumatoid Arthritis: How Real is the Risk?. Drug Saf 2018; 41: 645-653