For some patients with severe alopecia areata, a low dose of the Janus kinase 1/2 inhibitor ruxolitinib can achieve complete or near-complete hair regrowth, according to a study published in the Journal of the American Academy of Dermatology.

The study included 8 patients with severe alopecia areata, alopecia totalis, or alopecia universalis who were followed for 5 to 31 months (mean=13.9, SD=8.5) while receiving low-dose ruxolitinib monotherapy (10-25 mg twice a day). At baseline, the mean alopecia episode duration was 2.8 years, and 6  patients were non-responsive or not satisfied with their response to the Janus kinase 1/3 inhibitor tofacitinib.

Complete or near-complete hair regrowth occurred in 5 patients, with a 98% improvement in the Severity of Alopecia Tool score. Of these responders, 4 responded with the lowest dose of ruxolitinib at 10 mg twice a day. Hair regrowth did not occur in the remaining 3 patients. Overall, adverse events were mild and included upper respiratory infections, weight gain, acne, bruising, and fatigue.

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Future studies need to further examine the effects of the different Janus kinase inhibitors on alopecia areata, increase sample size, and include a control group for comparison.

Overall, the study results demonstrate that complete or near-complete hair regrowth is possible with lower dosages of ruxolitinib for some patients with severe alopecia areata.

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Disclosures: One author expressed a potential conflict of interest with numerous pharmaceutical companies. See source article for more information.

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Liu LY, King BA. Ruxolitinib for the treatment of severe alopecia areata [published online September 6, 2018]. J Am Acad Dermatol. doi: 10.1016/j.jaad.2018.08.040