Tofacitinib Reverses Plaque Psoriasis in Alopecia Universalis Patient

Although tofacitinib is typically used to treat rheumatoid arthritis (RA), researchers at Yale University discovered the drug effectively reversed alopecia universalis (AU) in a patient with plaque psoriasis.

For their study published in the Journal of Investigative Dermatology, dermatologists Brittany G. Craiglow and Brett A. King prescribed tofacitinib to a 25-year-old male whose alopecia areata (AA) was diagnosed at age 2 and progressed to AU by age 18. Hair growth was only observed in the plaques on his head.

According to a statement provided by Yale University, AU, which is considered to be incurable and untreatable, prevents affected patients from growing any body hair.

To determine tofacitinib’s effectiveness in AU, the researchers instructed the patient to take 5 mg of the drug twice-daily for 2-month period, after which the daily dosage was increased to 15 mg.

Despite the incurable status of AU, the patient began to grow scalp and facial hair after 2 months of treatment. By 3 months, the investigators reported the subject’s scalp hair had grown back completely, and after 8 months, he experienced full hair regrowth with no side effects. However, the patient did not grow hair on his arms and legs, which he claimed was naturally sparse prior to his AU diagnosis.

Nevertheless, the investigators reported the patient saw limited improvement to his psoriasis. Though they claimed increasing the dose of tocacitinib could fully treat the psoriasis, they noted “the patient is so pleased with the regrowth of his hair that he has chosen to continue at the present dose.”

In the statement, King touted tocacitinib as the first successful pathogenesis-based therapy for AU. Going forward, King recommended supplementary clinical trials to deduce the drug’s effect on AA and its variants, as well as pinpoint other successful Janus kinase (JAK) inhibitors.

“This is a huge step forward in the treatment of patients with this condition,” King commented. “While it’s one case, we anticipated the successful treatment of this man based on our current understanding of the disease and the drug. We believe the same results will be duplicated in other patients, and we plan to try.”