Safety and efficacy of the JAK inhibitor tofacitinib citrate in patients with alopecia areata.
5/5 보강
TL;DR
At the dose and duration studied, tofacitinib is a safe and effective treatment for severe AA, though it does not result in a durable response.
📑 코퍼스 인용 관계
· 인용됨 99 · 인용함 18
→ 이 논문이 인용한 논문 (6) ▾
- Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata… JCI insight · 2016
- Master regulators of infiltrate recruitment in autoimmune disease identified through netwo… Cell systems · 2015
- Pharmacologic inhibition of JAK-STAT signaling promotes hair growth. Science advances · 2015
- Genome-wide meta-analysis in alopecia areata resolves HLA associations and reveals two new… Nature communications · 2015
- Reversal of Alopecia Areata Following Treatment With the JAK1/2 Inhibitor Baricitinib. EBioMedicine · 2015
- Alopecia areata is driven by cytotoxic T lymphocytes and is reversed by JAK inhibition. Nature medicine · 2014
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연도별 인용 (2016–2026) · 합계 335
OpenAlex 토픽 ·
Hair Growth and Disorders
Dermatology and Skin Diseases
Psoriasis: Treatment and Pathogenesis
🇰🇷 한글 요약 🌐 Abstract
【연구 목적】
원형 탈모증(alopecia areata, AA)은 효과적인 치료법이 부족한 자가면역 질환으로, 본 연구는 JAK 억제제인 토파시티닙(tofacitinib citrate)의 중증 AA에 대한 안전성과 유효성을 체계적으로 평가하고자 했다.
【방법】
2개 기관 공개-단일군(open-label, single-arm) 시험으로, 두피(scalp) 모발 50% 이상 소실, 전두 탈모증(alopecia totalis, AT), 전신 탈모증(alopecia universalis, AU) 환자 66명에게 토파시티닙 5 mg을 1일 2회, 3개월간 투여했다. 1차 평가지표는 SALT(Severity of Alopecia Tool) 점수 변화와 치료 종료 후 모발 유지 기간이었다.
【주요 결과】
전체 환자의 32%에서 SALT 점수 50% 이상 호전을 보였으며, AA 및 ophiasis 아형이 AT·AU 아형보다 반응이 우수했다. 짧은 유병 기간과 치료 전 조직검사에서 모낭 주위 염증(peribulbar inflammation) 소견이 좋은 반응을 예측했고, 약물 중단 시 평균 8.5주 만에 재발했으며, 이상반응은 1~2등급의 경미한 감염에 국한되었다.
【임상적 시사점 (성형외과 의사 관점)】
모발이식 후보 평가나 난치성 탈모 환자 상담 시, 중증 AA·AT·AU 환자에서 모발이식보다 토파시티닙 등 JAK 억제제 의뢰가 우선 고려될 수 있음을 인지해야 한다(활동성 자가면역 탈모는 이식 모낭도 공격받을 위험이 있음). 다만 약물 중단 후 8.5주 내 재발하므로 장기 유지 전략이 필요하며, 유병 기간이 짧고 모낭 주위 염증이 있는 환자가 예후가 좋다는 점은 환자 선별과 피부과 협진 시점 결정에 유용하다.
[BACKGROUND] Alopecia areata (AA) is an autoimmune disease characterized by hair loss mediated by CD8 T cells. There are no reliably effective therapies for AA. Based on recent developments in the understanding of the pathomechanism of AA, JAK inhibitors appear to be a therapeutic option; however, their efficacy for the treatment of AA has not been systematically examined.
[METHODS] This was a 2-center, open-label, single-arm trial using the pan-JAK inhibitor, tofacitinib citrate, for AA with >50% scalp hair loss, alopecia totalis (AT), and alopecia universalis (AU). Tofacitinib (5 mg) was given twice daily for 3 months. Endpoints included regrowth of scalp hair, as assessed by the severity of alopecia tool (SALT), duration of hair growth after completion of therapy, and disease transcriptome.
[RESULTS] Of 66 subjects treated, 32% experienced 50% or greater improvement in SALT score. AA and ophiasis subtypes were more responsive than AT and AU subtypes. Shorter duration of disease and histological peribulbar inflammation on pretreatment scalp biopsies were associated with improvement in SALT score. Drug cessation resulted in disease relapse in 8.5 weeks. Adverse events were limited to grade I and II infections. An AA responsiveness to JAK/STAT inhibitors score was developed to segregate responders and nonresponders, and the previously developed AA disease activity index score tracked response to treatment.
[CONCLUSIONS] At the dose and duration studied, tofacitinib is a safe and effective treatment for severe AA, though it does not result in a durable response. Transcriptome changes reveal unexpected molecular complexity within the disease.
[TRIAL REGISTRATION] ClinicalTrials.gov NCT02197455 and NCT02312882.
[FUNDING] This work was supported by the US Department of Veterans Affairs Office of Research and Development, National Institute of Arthritis and Musculoskeletal and Skin Diseases National Institutes of Health grant R01 AR47223 and U01 AR67173, the National Psoriasis Foundation, the Swedish Society of Medicine, the Fernström Foundation, the Locks of Love Foundation, the National Alopecia Areata Foundation, and the Ranjini and Ajay Poddar Resource Fund for Dermatologic Diseases Research.
[METHODS] This was a 2-center, open-label, single-arm trial using the pan-JAK inhibitor, tofacitinib citrate, for AA with >50% scalp hair loss, alopecia totalis (AT), and alopecia universalis (AU). Tofacitinib (5 mg) was given twice daily for 3 months. Endpoints included regrowth of scalp hair, as assessed by the severity of alopecia tool (SALT), duration of hair growth after completion of therapy, and disease transcriptome.
[RESULTS] Of 66 subjects treated, 32% experienced 50% or greater improvement in SALT score. AA and ophiasis subtypes were more responsive than AT and AU subtypes. Shorter duration of disease and histological peribulbar inflammation on pretreatment scalp biopsies were associated with improvement in SALT score. Drug cessation resulted in disease relapse in 8.5 weeks. Adverse events were limited to grade I and II infections. An AA responsiveness to JAK/STAT inhibitors score was developed to segregate responders and nonresponders, and the previously developed AA disease activity index score tracked response to treatment.
[CONCLUSIONS] At the dose and duration studied, tofacitinib is a safe and effective treatment for severe AA, though it does not result in a durable response. Transcriptome changes reveal unexpected molecular complexity within the disease.
[TRIAL REGISTRATION] ClinicalTrials.gov NCT02197455 and NCT02312882.
[FUNDING] This work was supported by the US Department of Veterans Affairs Office of Research and Development, National Institute of Arthritis and Musculoskeletal and Skin Diseases National Institutes of Health grant R01 AR47223 and U01 AR67173, the National Psoriasis Foundation, the Swedish Society of Medicine, the Fernström Foundation, the Locks of Love Foundation, the National Alopecia Areata Foundation, and the Ranjini and Ajay Poddar Resource Fund for Dermatologic Diseases Research.
【연구 목적】 원형 탈모증(alopecia areata, AA)은 효과적인 치료법이 부족한 자가면역 질환으로, 본 연구는 JAK 억제제인 토파시티닙(tofacitinib citrate)의 중증 AA에 대한 안전성과 유효성을 체계적으로 평가하고자 했다.
APA 7
M, K. C., Ko, J. M., Craiglow, B. G., Li, S., Shankar, G., Urban, J. R., Chen, J. C., Cerise, J. E., Jabbari, A., Winge, M. C., Marinkovich, M. P., Christiano, A. M., Oro, A. E., & King, B. A. (2016). Safety and efficacy of the jak inhibitor tofacitinib citrate in patients with alopecia areata.. JCI insight, 1(15), e89776. https://doi.org/10.1172/jci.insight.89776
Vancouver
M KC, Ko JM, Craiglow BG, Li S, Shankar G, Urban JR, et al. Safety and efficacy of the JAK inhibitor tofacitinib citrate in patients with alopecia areata. JCI insight. 2016;1(15):e89776. doi:10.1172/jci.insight.89776
AMA 11
M KC, Ko JM, Craiglow BG, Li S, Shankar G, Urban JR, et al. Safety and efficacy of the JAK inhibitor tofacitinib citrate in patients with alopecia areata. JCI insight. 2016;1(15):e89776. doi:10.1172/jci.insight.89776
Chicago
M, K. C., Ko, J. M., Craiglow, B. G., Li, S., Shankar, G., Urban, J. R., Chen, J. C., Cerise, J. E., Jabbari, A., Winge, M. C., and .... 2016. "Safety and efficacy of the JAK inhibitor tofacitinib citrate in patients with alopecia areata." JCI insight 1 (15): e89776. https://doi.org/10.1172/jci.insight.89776
MLA 9
M, K. C., et al. "Safety and efficacy of the JAK inhibitor tofacitinib citrate in patients with alopecia areata." JCI insight, vol. 1, no. 15, 2016, pp. e89776. doi:10.1172/jci.insight.89776.
PMID
27699252 ↗
추출된 의학 개체 (NER)
전체 NER 표 보기
| 유형 | 영어 표현 | 한국어 / 풀이 | UMLS CUI | 출처 | 등장 |
|---|---|---|---|---|---|
| 해부 | scalp
|
두피 | dict | 3 | |
| 해부 | scalp
|
두피 | dict | 3 | |
| 질환 | alopecia areata
|
원형 탈모증 | dict | 3 | |
| 질환 | alopecia areata
|
원형 탈모증 | dict | 3 |
🏷️ 키워드 / MeSH 📖 같은 키워드 OA만
인용 관계
그래프 OA 노드: 13/16 (81%)
· 참조 7편 · 후속 6편
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- Genome-wide association study in alopecia areata implicates both innate and adaptive immunity.
- Genome-wide meta-analysis in alopecia areata resolves HLA associations and reveals two new susceptib…
- Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata.
- Pharmacologic inhibition of JAK-STAT signaling promotes hair growth.
- Reversal of Alopecia Areata Following Treatment With the JAK1/2 Inhibitor Baricitinib.
- Interventions for alopecia areata.
- Master regulators of infiltrate recruitment in autoimmune disease identified through network-based m…
이 논문을 인용한 후속 연구 20
- Alopecia areata.
- Alopecia Areata: an Update on Etiopathogenesis, Diagnosis, and Management.
- Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata.
- An Open-Label Pilot Study to Evaluate the Efficacy of Tofacitinib in Moderate to Severe Patch-Type A…
- Alopecia areata: a review on diagnosis, immunological etiopathogenesis and treatment options.
- Alopecia Areata: Review of Epidemiology, Clinical Features, Pathogenesis, and New Treatment Options.
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- JAK inhibitors in dermatology: The promise of a new drug class.
- Alopecia Areata: Current Treatments and New Directions.
- Treatment of Alopecia Areata With Tofacitinib.
- The efficacy and safety of JAK inhibitors for alopecia areata: A systematic review and meta-analysis…
- The Changing Landscape of Alopecia Areata: The Therapeutic Paradigm.
- JAK Inhibitors for Treatment of Alopecia Areata.
- Baricitinib for the Treatment of Alopecia Areata.
- A Comprehensive Literature Review of JAK Inhibitors in Treatment of Alopecia Areata.
- The Effect of JAK Inhibitor on the Survival, Anagen Re-Entry, and Hair Follicle Immune Privilege Res…
- Tofacitinib for the treatment of lichen planopilaris: A case series.
- Alopecia Areata: Burden of Disease, Approach to Treatment, and Current Unmet Needs.
- The current state of knowledge of the immune ecosystem in alopecia areata.
🏷️ 같은 키워드 · 무료전문 — 이 논문 MeSH/keyword 기반
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- 양성 전립선 비대증의 임상적 진행에 대한 doxazosin, finasteride 및 병용 요법의 장기 효과.
- 양성 전립선 비대증 환자에서 finasteride의 효과. The Finasteride Study Group.
- 양성 전립선 비대증 남성에서 급성 요폐의 위험과 수술적 치료 필요성에 대한 finasteride의 효과. Finasteride Long-Term Efficacy and Safety Study Group.
- 원형 탈모.
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