Dermatología en Costa Rica

Tuesday, December 06, 2016

Nuevo tratamiento a considerar en alopecia areata gana mas estudios!

Tofacitinib Shows Promise for Treating Severe Alopecia Areata

By Will Boggs MD

December 02, 2016
 

NEW YORK (Reuters Health) - The Janus kinase (JAK) inhibitor tofacitinib shows promise for treating severe alopecia areata and its variants in adults and adolescents, according to two retrospective studies.

"For patients with severe alopecia areata, alopecia totalis, and alopecia universalis, tofacitinib is first-line therapy," Dr. Brett A. King from Yale University in New Haven, Connecticut, told Reuters Health by email.

Alopecia areata (AA) is a common autoimmune disorder that affects both children and adults. There is no reliably effective treatment, Dr. King and colleagues write in the Journal of the American Academy of Dermatology, online November 2.

Following favorable results from a short-term open-label clinical trial of tofacitinib, the researchers analyzed records on 90 patients, 78 of whom continued to take the drug. Age at onset ranged from 1.5 to 65 years, and disease duration ranged from two to 54 years.

Among the 65 patients classified as potential responders - based on disease duration of 10 years or less for those with alopecia totalis (AT) or alopecia universalis (AU) - 20% were complete responders to tofacitinib, 38.4% were intermediate responders, and 18.5% were moderate responders. Fifteen patients (23.1%) were nonresponders.

Only eight of the 25 patients classified as less likely to respond to treatment showed a clinical response.

Patients with AA had significantly higher percent improvements in Severity of Alopecia Tool (SALT) scores (median, 81.9%) compared with AT/AU patients (59.0%).

There were no serious adverse events over a median duration of 12 months of treatment.

"The expanded experience regarding treatment of severe AA provided by this study will help to guide clinical trials, which will be important for detailing the efficacy and safety of JAK inhibitors in this disease," the researchers note.

In a companion report, Dr. King and colleagues detail the experience of 13 adolescent patients with AA treated with tofacitinib for a median of five months.

Ten patients experienced hair regrowth, one of whom was later deemed a non-responder because of the loss of hair that had regrown. The other three patients experienced only very minimal regrowth.

Median improvements in SALT score were 93% overall and 100% among responders.

Adverse events were mild and included headaches in three patients, upper respiratory infections in four, and mild increases in liver enzymes in four, all of which returned to normal when rechecked despite ongoing tofacitinib therapy.

"Tofacitinib should be considered for the treatment of severe alopecia areata, alopecia totalis, and alopecia universalis," Dr. King concluded. "Because the onset of AA is frequently in early childhood or adolescence, often a vulnerable time for patients and families, tofacitinib treatment of severe AA might be considered in adolescents."

"Alopecia areata is often associated with poor health-related quality of life, and its association with psychiatric conditions including anxiety and depression is well documented," he added. "It is not a cosmetic condition, but rather a medical disorder that merits treatment."

SOURCE: http://bit.ly/2gY3ynt and http://bit.ly/2gLtj7p

J Am Acad Dermatol 2016.


Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica
4000-1054
2208-8206
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