Effectiveness and safety of oral tofacitinib in patients with recalcitrant frontal fibrosing alopecia : a pilot study

Name: Viyada Tamprateep

MeSH: Alopecia -- therapy

MeSH: Patients -- Safety measures

MeSH: Tofacitinib

Abstract: Frontal fibrosing alopecia (FFA) predominantly affects women aged 50–60 and is characterized by symmetrical hairline recession with redness and scaling. Treatments including hydroxychloroquine, corticosteroids and Janus kinase (JAK) inhibitors show promising results, although no standard guidelines exist. Studies indicate that tofacitinib, a JAK1/3 inhibitor, is effective in treating FFA, with reported symptom improvement ranging from 30% to 94% compared to baseline. However, large-scale studies demonstrating optimal outcomes are lacking and there might be financial constraints and logistical issues for patients. Assessing the effectiveness and safety of tofacitinib could provide valuable insights into its potential benefits against FFA, addressing a significant unmet medical need. The pilot single-arm study aimed to evaluate effectiveness and safety of tofacitinib in Thai patients with recalcitrant FFA, addressing treatment effectiveness and safety concerns in this population. This study involved 11 eligible participants who underwent a 12-week treatment regimen of oral tofacitinib at a daily dose of 10 mg for FFA. Assessments included the Frontal Fibrosing Alopecia Severity Index (FFASI), the Frontal Fibrosing Alopecia Severity Score (FFASS), the Lichen Planopilaris Activity Index (LPPAI), and photographic and dermoscopic evaluations. Descriptive statistics and statistical tests, including the Wilcoxon rank test, were used for data analysis. The qualitative clinical outcome was evaluated by dermatoscopy examination. There are statistically significant improvements in FFASI (47.5 to 44.0, p = 0.045) and FFASS (16.3 to 15.9, p = 0.016) at week 16, while LPPAI did not show significant changes (median 1.83 vs. 1.33, p = 0.13). Safety monitoring included surveillance for adverse events and laboratory assessments. By week 16, four out of eleven (36.4%) of participants experienced mild acne vulgaris, while five out of them (45.5%) had a slight increase in cholesterol. Three in five (60%) of those with dyslipidemia sought treatment from specialists, and two out of three (66.7%) were able to normalize their cholesterol levels with medication. These results offer preliminary support for effectiveness of tofacitinib as a treatment for FFA. However, additional studies with extended follow-up periods and larger participant groups are required to substantiate its effectiveness and safety

Rangsit University Library

Address: Pathumthani

Email: library@rsu.ac.th

Name: Wanida Limpongsanurak

Role: Advisor

Created: 2024

Modified: 2569-02-25

Issued: 2026-02-25

วิทยานิพนธ์/Thesis

application/pdf

eng

DegreeName: Master of Science

Level: Master's Degree

Descipline: Dermatology and Dermatosurgery

Grantor: Rangsit University

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