Alopecia Universalis Unresponsive to Treatment with Tofacitinib: Report of a Case with a Brief Review of the Literature

The case report described a patient with alopecia universalis who did not respond to a 3-month treatment with tofacitinib, despite the initial dose being 5 mg twice daily, which was consistent with doses used in other studies. Out of 8 patients treated with tofacitinib, 6 showed at least partial improvement, while 2, including the patient in this report, did not respond. The authors suggested that JAK1/2 inhibition via ruxolitinib and baricitinib might be more effective than JAK1/3 inhibition with tofacitinib for treating alopecia areata (AA). They concluded that JAK inhibition might not be effective for every AA patient and emphasized the need for further studies on the efficacy of different JAK inhibitors and patient characteristics that predict a good response.