Successful Treatment of Severe Diffuse Alopecia Areata with Abrocitinib

This document reports on a case series involving six patients with severe diffuse alopecia areata (AA) treated with abrocitinib, a JAK1 inhibitor. The patients, aged 27 to 52, had a Severity of Alopecia Tool (SALT) score of ≥50, indicating severe AA, and were treated with 100 mg of abrocitinib daily for at least 12 weeks. Results showed significant improvement, with all patients achieving a SALT score ≤20 after 8 weeks, and four out of six patients achieving complete recovery within 12 weeks. The treatment was well-tolerated with no adverse events reported. The study suggests that concurrent atopic diseases, such as allergic rhinitis and elevated serum IgE levels, might predict a positive response to abrocitinib. The authors advocate for further randomized controlled trials to assess the efficacy and safety of abrocitinib for severe AA.