Unorthodox-dosed tofacitinib, baricitinib exhibit similar efficacy in paediatric alopecia

The efficacy of unorthodox dosing regimens of tofacitinib and baricitinib is comparable among paediatric patients with moderate-to-severe alopecia areata over 24 weeks and has a manageable safety profile, reports a recent study.

Some 100 paediatric patients (severity of alopecia tool [SALT] score 21‒100) were randomly assigned in a 1:1 ratio to receive either tofacitinib (n=51) or baricitinib (n=49). The primary outcomes were SALT score ≤10 (moderate, 21‒49) and SALT score ≤20 (severe, 50‒94; very severe, 95‒100) at week 24.

The proportion of patients who achieved SALT score ≤10 (p=0.87) was 33.33 percent in the tofacitinib arm and 41.18 percent in the baricitinib arm.

For severe patients, 45.45 percent in the tofacitinib arm and 30.77 percent in the baricitinib arm achieved SALT score ≤20 (p=0.75). Furthermore, 47.37 percent of very severe patients treated with tofacitinib and 31.58 percent of those treated with baricitinib achieved SALT score ≤20 (p=0.51).

The proportion of patients who achieved SALT₉₀ was numerically higher in the baricitinib group than that in the tofacitinib group (36.73 percent vs 21.57 percent; p=0.16). Both regimens were well-tolerated, with no reports of serious adverse events.

“Unorthodox-dosed tofacitinib and baricitinib showed comparable efficacy and were well-tolerated in paediatric alopecia areata over 24 weeks, supporting short-term use,” the researchers said.

The study was limited by its short duration, and efficacy findings may not be generalizable to standard dosing regimens, according to the researchers.