Tofacitinib for the treatment of lichen planopilaris: A case series
Lichen planopilaris (LPP) is an inflammatory cicatricial alopecia for which many different therapies are attempted with varying success. The Janus kinase (JAK) inhibitor, tofacitinib, has been shown to be effective in treating the noncicatricial alopecia, alopecia areata. As in alopecia areata, upre...
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| Veröffentlicht in: | Dermatologic therapy 2018-11, Vol.31 (6), p.e12656-n/a |
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| description | Lichen planopilaris (LPP) is an inflammatory cicatricial alopecia for which many different therapies are attempted with varying success. The Janus kinase (JAK) inhibitor, tofacitinib, has been shown to be effective in treating the noncicatricial alopecia, alopecia areata. As in alopecia areata, upregulation of interferon and JAK signaling may play a role in LPP. We retrospectively reviewed the cases of 10 patients with recalcitrant LPP who were treated with oral tofacitinib. Patients received oral tofacitinib 5 mg twice or three times daily for 2–19 months as either monotherapy or adjunctive therapy to other ongoing treatments including intralesional triamcinolone, hydroxychloroquine, and tacrolimus ointment. Eight patients had clinical improvement in LPP with tofacitinib as either monotherapy (4/10) or adjunctive therapy (4/10). LPP Activity Index (LPPAI) before and after treatment was measured in seven patients and was significantly different (6.22 before treatment, 3.08 after treatment; p value = .0014). Reduction in LPPAI ranged from 30 to 94%. One patient complained of 10 pound (4.5 kg) weight gain after 12 months on tofacitinib. No other adverse effects were reported. Treatment with oral tofacitinib either as monotherapy or adjunctive therapy can lead to measurable improvement in recalcitrant LPP. |
| doi_str_mv | 10.1111/dth.12656 |
| format | Article |
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The Janus kinase (JAK) inhibitor, tofacitinib, has been shown to be effective in treating the noncicatricial alopecia, alopecia areata. As in alopecia areata, upregulation of interferon and JAK signaling may play a role in LPP. We retrospectively reviewed the cases of 10 patients with recalcitrant LPP who were treated with oral tofacitinib. Patients received oral tofacitinib 5 mg twice or three times daily for 2–19 months as either monotherapy or adjunctive therapy to other ongoing treatments including intralesional triamcinolone, hydroxychloroquine, and tacrolimus ointment. Eight patients had clinical improvement in LPP with tofacitinib as either monotherapy (4/10) or adjunctive therapy (4/10). LPP Activity Index (LPPAI) before and after treatment was measured in seven patients and was significantly different (6.22 before treatment, 3.08 after treatment; p value = .0014). Reduction in LPPAI ranged from 30 to 94%. One patient complained of 10 pound (4.5 kg) weight gain after 12 months on tofacitinib. No other adverse effects were reported. Treatment with oral tofacitinib either as monotherapy or adjunctive therapy can lead to measurable improvement in recalcitrant LPP.</description><identifier>ISSN: 1396-0296</identifier><identifier>EISSN: 1529-8019</identifier><identifier>DOI: 10.1111/dth.12656</identifier><identifier>PMID: 30264512</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Administration, Oral ; Adult ; Aged ; alopecia ; Alopecia - diagnosis ; Alopecia - drug therapy ; Alopecia - enzymology ; Dermatologic Agents - administration & dosage ; Dermatologic Agents - adverse effects ; Drug Administration Schedule ; Female ; frontal fibrosing alopecia ; Humans ; JAK inhibitors ; Janus Kinase Inhibitors - administration & dosage ; Janus Kinase Inhibitors - adverse effects ; lichen planopilaris ; Lichen Planus - diagnosis ; Lichen Planus - drug therapy ; Lichen Planus - enzymology ; Male ; Middle Aged ; Piperidines - administration & dosage ; Piperidines - adverse effects ; Pyrimidines - administration & dosage ; Pyrimidines - adverse effects ; Pyrroles - administration & dosage ; Pyrroles - adverse effects ; Remission Induction ; Retrospective Studies ; Scalp ; Scalp Dermatoses - diagnosis ; Scalp Dermatoses - drug therapy ; Scalp Dermatoses - enzymology ; scarring alopecia ; Skin - drug effects ; Skin - enzymology ; Skin - pathology ; Therapeutic Hotline: Short Paper ; Therapeutic Hotline: Short Papers ; Time Factors ; tofacitinib ; Treatment Outcome</subject><ispartof>Dermatologic therapy, 2018-11, Vol.31 (6), p.e12656-n/a</ispartof><rights>2018 The Authors. Dermatologic Therapy published by Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4156-a7458dc217ff82058d336057385d6e7a576a3e43d04b753194b7c35bd33395953</citedby><cites>FETCH-LOGICAL-c4156-a7458dc217ff82058d336057385d6e7a576a3e43d04b753194b7c35bd33395953</cites><orcidid>0000-0001-7822-394X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdth.12656$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdth.12656$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,777,781,882,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30264512$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Christine C.</creatorcontrib><creatorcontrib>Khanna, Trisha</creatorcontrib><creatorcontrib>Sallee, Brigitte</creatorcontrib><creatorcontrib>Christiano, Angela M.</creatorcontrib><creatorcontrib>Bordone, Lindsey A.</creatorcontrib><title>Tofacitinib for the treatment of lichen planopilaris: A case series</title><title>Dermatologic therapy</title><addtitle>Dermatol Ther</addtitle><description>Lichen planopilaris (LPP) is an inflammatory cicatricial alopecia for which many different therapies are attempted with varying success. The Janus kinase (JAK) inhibitor, tofacitinib, has been shown to be effective in treating the noncicatricial alopecia, alopecia areata. As in alopecia areata, upregulation of interferon and JAK signaling may play a role in LPP. We retrospectively reviewed the cases of 10 patients with recalcitrant LPP who were treated with oral tofacitinib. Patients received oral tofacitinib 5 mg twice or three times daily for 2–19 months as either monotherapy or adjunctive therapy to other ongoing treatments including intralesional triamcinolone, hydroxychloroquine, and tacrolimus ointment. Eight patients had clinical improvement in LPP with tofacitinib as either monotherapy (4/10) or adjunctive therapy (4/10). LPP Activity Index (LPPAI) before and after treatment was measured in seven patients and was significantly different (6.22 before treatment, 3.08 after treatment; p value = .0014). Reduction in LPPAI ranged from 30 to 94%. One patient complained of 10 pound (4.5 kg) weight gain after 12 months on tofacitinib. No other adverse effects were reported. Treatment with oral tofacitinib either as monotherapy or adjunctive therapy can lead to measurable improvement in recalcitrant LPP.</description><subject>Administration, Oral</subject><subject>Adult</subject><subject>Aged</subject><subject>alopecia</subject><subject>Alopecia - diagnosis</subject><subject>Alopecia - drug therapy</subject><subject>Alopecia - enzymology</subject><subject>Dermatologic Agents - administration & dosage</subject><subject>Dermatologic Agents - adverse effects</subject><subject>Drug Administration Schedule</subject><subject>Female</subject><subject>frontal fibrosing alopecia</subject><subject>Humans</subject><subject>JAK inhibitors</subject><subject>Janus Kinase Inhibitors - administration & dosage</subject><subject>Janus Kinase Inhibitors - adverse effects</subject><subject>lichen planopilaris</subject><subject>Lichen Planus - diagnosis</subject><subject>Lichen Planus - drug therapy</subject><subject>Lichen Planus - enzymology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Piperidines - administration & dosage</subject><subject>Piperidines - adverse effects</subject><subject>Pyrimidines - administration & dosage</subject><subject>Pyrimidines - adverse effects</subject><subject>Pyrroles - administration & dosage</subject><subject>Pyrroles - adverse effects</subject><subject>Remission Induction</subject><subject>Retrospective Studies</subject><subject>Scalp</subject><subject>Scalp Dermatoses - diagnosis</subject><subject>Scalp Dermatoses - drug therapy</subject><subject>Scalp Dermatoses - enzymology</subject><subject>scarring alopecia</subject><subject>Skin - drug effects</subject><subject>Skin - enzymology</subject><subject>Skin - pathology</subject><subject>Therapeutic Hotline: Short Paper</subject><subject>Therapeutic Hotline: Short Papers</subject><subject>Time Factors</subject><subject>tofacitinib</subject><subject>Treatment Outcome</subject><issn>1396-0296</issn><issn>1529-8019</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp1kD1PwzAQhi0EoqUw8AeQV4a0_oidmAGpCh9FqsRSZstxHGKUxpEdQP33GAIVDHi5k-7xc6cXgHOM5ji-RTU0c0w44wdgihkRSY6wOIw9FTxBRPAJOAnhBSFMBMXHYEIR4SnDZAqKjauVtoPtbAlr5-HQGDh4o4at6Qboatha3ZgO9q3qXG9b5W24gkuoVTAwGG9NOAVHtWqDOfuuM_B0d7spVsn68f6hWK4TnWLGE5WlLK80wVld5wTFnlKOWEZzVnGTKZZxRU1KK5SWGaNYxKIpKyNGBROMzsD16O1fy62pdDzQq1b23m6V30mnrPw76Wwjn92b5CxnWYqi4HIUaO9C8Kbe_8VIfiYpY5LyK8nIXvxetid_oovAYgTebWt2_5vkzWY1Kj8A03F9CQ</recordid><startdate>201811</startdate><enddate>201811</enddate><creator>Yang, Christine C.</creator><creator>Khanna, Trisha</creator><creator>Sallee, Brigitte</creator><creator>Christiano, Angela M.</creator><creator>Bordone, Lindsey A.</creator><general>John Wiley & Sons, Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-7822-394X</orcidid></search><sort><creationdate>201811</creationdate><title>Tofacitinib for the treatment of lichen planopilaris: A case series</title><author>Yang, Christine C. ; Khanna, Trisha ; Sallee, Brigitte ; Christiano, Angela M. ; Bordone, Lindsey A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4156-a7458dc217ff82058d336057385d6e7a576a3e43d04b753194b7c35bd33395953</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Administration, Oral</topic><topic>Adult</topic><topic>Aged</topic><topic>alopecia</topic><topic>Alopecia - diagnosis</topic><topic>Alopecia - drug therapy</topic><topic>Alopecia - enzymology</topic><topic>Dermatologic Agents - administration & dosage</topic><topic>Dermatologic Agents - adverse effects</topic><topic>Drug Administration Schedule</topic><topic>Female</topic><topic>frontal fibrosing alopecia</topic><topic>Humans</topic><topic>JAK inhibitors</topic><topic>Janus Kinase Inhibitors - administration & dosage</topic><topic>Janus Kinase Inhibitors - adverse effects</topic><topic>lichen planopilaris</topic><topic>Lichen Planus - diagnosis</topic><topic>Lichen Planus - drug therapy</topic><topic>Lichen Planus - enzymology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Piperidines - administration & dosage</topic><topic>Piperidines - adverse effects</topic><topic>Pyrimidines - administration & dosage</topic><topic>Pyrimidines - adverse effects</topic><topic>Pyrroles - administration & dosage</topic><topic>Pyrroles - adverse effects</topic><topic>Remission Induction</topic><topic>Retrospective Studies</topic><topic>Scalp</topic><topic>Scalp Dermatoses - diagnosis</topic><topic>Scalp Dermatoses - drug therapy</topic><topic>Scalp Dermatoses - enzymology</topic><topic>scarring alopecia</topic><topic>Skin - drug effects</topic><topic>Skin - enzymology</topic><topic>Skin - pathology</topic><topic>Therapeutic Hotline: Short Paper</topic><topic>Therapeutic Hotline: Short Papers</topic><topic>Time Factors</topic><topic>tofacitinib</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Christine C.</creatorcontrib><creatorcontrib>Khanna, Trisha</creatorcontrib><creatorcontrib>Sallee, Brigitte</creatorcontrib><creatorcontrib>Christiano, Angela M.</creatorcontrib><creatorcontrib>Bordone, Lindsey A.</creatorcontrib><collection>Wiley Open Access</collection><collection>Wiley Free Archive</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Dermatologic therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Christine C.</au><au>Khanna, Trisha</au><au>Sallee, Brigitte</au><au>Christiano, Angela M.</au><au>Bordone, Lindsey A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tofacitinib for the treatment of lichen planopilaris: A case series</atitle><jtitle>Dermatologic therapy</jtitle><addtitle>Dermatol Ther</addtitle><date>2018-11</date><risdate>2018</risdate><volume>31</volume><issue>6</issue><spage>e12656</spage><epage>n/a</epage><pages>e12656-n/a</pages><issn>1396-0296</issn><eissn>1529-8019</eissn><abstract>Lichen planopilaris (LPP) is an inflammatory cicatricial alopecia for which many different therapies are attempted with varying success. The Janus kinase (JAK) inhibitor, tofacitinib, has been shown to be effective in treating the noncicatricial alopecia, alopecia areata. As in alopecia areata, upregulation of interferon and JAK signaling may play a role in LPP. We retrospectively reviewed the cases of 10 patients with recalcitrant LPP who were treated with oral tofacitinib. Patients received oral tofacitinib 5 mg twice or three times daily for 2–19 months as either monotherapy or adjunctive therapy to other ongoing treatments including intralesional triamcinolone, hydroxychloroquine, and tacrolimus ointment. Eight patients had clinical improvement in LPP with tofacitinib as either monotherapy (4/10) or adjunctive therapy (4/10). LPP Activity Index (LPPAI) before and after treatment was measured in seven patients and was significantly different (6.22 before treatment, 3.08 after treatment; p value = .0014). Reduction in LPPAI ranged from 30 to 94%. One patient complained of 10 pound (4.5 kg) weight gain after 12 months on tofacitinib. No other adverse effects were reported. Treatment with oral tofacitinib either as monotherapy or adjunctive therapy can lead to measurable improvement in recalcitrant LPP.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>30264512</pmid><doi>10.1111/dth.12656</doi><tpages>4</tpages><orcidid>https://orcid.org/0000-0001-7822-394X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Administration, Oral Adult Aged alopecia Alopecia - diagnosis Alopecia - drug therapy Alopecia - enzymology Dermatologic Agents - administration & dosage Dermatologic Agents - adverse effects Drug Administration Schedule Female frontal fibrosing alopecia Humans JAK inhibitors Janus Kinase Inhibitors - administration & dosage Janus Kinase Inhibitors - adverse effects lichen planopilaris Lichen Planus - diagnosis Lichen Planus - drug therapy Lichen Planus - enzymology Male Middle Aged Piperidines - administration & dosage Piperidines - adverse effects Pyrimidines - administration & dosage Pyrimidines - adverse effects Pyrroles - administration & dosage Pyrroles - adverse effects Remission Induction Retrospective Studies Scalp Scalp Dermatoses - diagnosis Scalp Dermatoses - drug therapy Scalp Dermatoses - enzymology scarring alopecia Skin - drug effects Skin - enzymology Skin - pathology Therapeutic Hotline: Short Paper Therapeutic Hotline: Short Papers Time Factors tofacitinib Treatment Outcome |
| title | Tofacitinib for the treatment of lichen planopilaris: A case series |
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