علاج الثعلبة البقعية المقاومة للعلاج مع إصابة 50% أو أكثر من فروة الرأس

References

DOI: 10.14924/dermatol.134.2491

Are Oral JAK Inhibitors or a JAK3/TEC Family Kinase Selective Inhibitor Useful for Treating Refractory AA Involving an Extensive Area?

The alopecia area is ≥ 50% of the scalp, and there was no spontaneous regeneration of hair in the past 6 months.

Baricitinib should be administered to pharmaceutical adults (aged ≥ 15 years; however, patients aged < 18 years were not included in the BRAVE-AA studies), and ritlecitinib tosilate to patients aged ≥ 12 years.

In Japan, baricitinib tablets and ritlecitinib tosilate capsules were approved for the treatment of severe refractory AA and are covered by health insurance.

Baricitinib is a JAK1/2 selective inhibitor. Ritlecitinib tosilate is a JAK3/TEC (tyrosine kinase expressed in hepatocellular carcinoma) family kinase selective inhibitor.

For the treatment of AA with a prolonged course, flexible management, such as the confirmation of a will to continue treatment and a proposal for the use of a wig, is necessary.

The BRAVE-AA2 study involving Japanese patients showed that the rate of patients achieving a SALT score of ≤ 20 (extent of alopecia: ≤ 20% of the scalp) after 36-week administration was 35.9% in the 4-mg-treated group (difference from placebo: 32.6%, 95% CI: 25.6 to 39.6) and 19.4% in the 2-mg-treated group (difference from placebo: 16.1%, 95% CI: 9.1 to 23.2); significant hair growth was observed in both groups versus placebo (3.3%).