Adjunctive Dupilumab Therapy in a Partial Responder to Baricitinib for Alopecia Areata
Main Article Content
Keywords
alopecia areata, jak inhibitors, biologics, dupilumab
Abstract
While oral janus kinase (JAK) inhibitors have revolutionized the treatment of severe alopecia areata, the majority of patients in the clinical trials still did not achieve the primary endpoint of SALT 201. There is a paucity of data on using combination immunomodulatory agents to optimize the treatment response in refractory cases. Herein, we report a case of a patient with severe alopecia areata with a predominant ophiasis pattern who partially responded to baricitinib 4mg daily and oral minoxidil after 15 months of therapy but had near complete hair regrowth just 2 months after adding dupilumab.
References
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8. Liu L, Yan YD, Shi FH, Lin HW, Gu ZC, Li J. Comparative efficacy and safety of JAK inhibitors as monotherapy and in combination with methotrexate in patients with active rheumatoid arthritis: A systematic review and meta-analysis. Front Immunol. 2022;13. doi:10.3389/FIMMU.2022.977265
2. Harries MJ, Sun J, Paus R, King LE. Management of alopecia areata. BMJ. 2010;341(7766):242-246. doi:10.1136/BMJ.C3671
3. Wambier CG, Craiglow BG, King BA. Combination tofacitinib and oral minoxidil treatment for severe alopecia areata. J Am Acad Dermatol. 2021;85(3):743-745. doi:10.1016/J.JAAD.2019.08.080
4. Guttman-Yassky E, Renert-Yuval Y, Bares J, et al. Phase 2a randomized clinical trial of dupilumab (anti-IL-4Rα) for alopecia areata patients. Allergy. 2022;77(3):897-906. doi:10.1111/ALL.15071
5. Flanagan K, Sperling L, Lin J. Drug-induced alopecia after dupilumab therapy. JAAD case reports. 2018;5(1):54-56. doi:10.1016/J.JDCR.2018.10.010
6. King B, Shapiro J, Ohyama M, et al. When to expect scalp hair regrowth during treatment of severe alopecia areata with baricitinib: insights from trajectories analyses of patients enrolled in two phase III trials. Br J Dermatol. 2023;189(6):666-673. doi:10.1093/BJD/LJAD253
7. Shahriari N, Strober B, Shahriari M. JAK-inhibitors as rescue therapy in dupilumab-refractory severe atopic dermatitis: A case series of 6 patients. JAAD Case Reports. 2023;33:81. doi:10.1016/J.JDCR.2023.01.020
8. Liu L, Yan YD, Shi FH, Lin HW, Gu ZC, Li J. Comparative efficacy and safety of JAK inhibitors as monotherapy and in combination with methotrexate in patients with active rheumatoid arthritis: A systematic review and meta-analysis. Front Immunol. 2022;13. doi:10.3389/FIMMU.2022.977265