While JAK inhibitors have emerged as treatment of alopecia areata, studies have focused on scalp hair growth. In this study, we evaluated the response of eyebrows and eyelashes to tofacitinib.

1. Response to Tofacitinib Therapy of Eyebrows and
Eyelashes in Alopecia Areata
Brett King, MD, PhD
Associate Professor of Dermatology
Yale University School of Medicine

2. Disclosures
I have received honoraria or consulting fees from: Aclaris
Therapeutics, Concert Pharmaceuticals, Eli Lilly, Pfizer, Roivant
Sciences
My wife, Britt Craiglow, has received honoraria and consulting
fees from: Pfizer

3. The clinical course of severe AA is unpredictable and there is little
data to guide expectations of disease course, with or without
treatment
There is involvement of the eyebrows and/or eyelashes in up to
76% of patients with AA
JAK inhibitors are efficacious for the treatment of AA, but studies
have focused on scalp hair growth
What is known

4. Baseline 2 months
tofacitinib 5 mg BID
5 months
tofa 10 + 5 mg daily
8 months
tofa 10 + 5 mg daily

5. Aim of study
• Evaluate the response of eyebrows and
eyelashes in patients with AA treated with the
JAK inhibitor, tofacitinib

6. Methods
• Records of all patients treated with tofacitinib and
evaluated between January 2014 and April 2018 were
identified
• Inclusion criteria for this study were:
– diagnosis of AA with scalp involvement in addition to
eyebrows or eyelashes involvement
– 6 months of tofacitinib therapy
– treatment responses were documented (absent, partial, or
complete).

7. Methods
119
Total patients
98 (82.4%)
Total scalp hair loss
86 (87.8%)
+ both eyebrows and
eyelash involvement
11 (11.2%)
+ eyebrows
involvement only
1 (1.0%)
+ eyelash
involvement only
21 (17.6%)
Subtotal scalp hair
loss
15 (71.4%)
+ both eyebrows and
eyelash involvement
3 (14.3%)
+ eyebrows
involvement only
3 (14.3%)
+ eyelash
involvement only

8. Results: Eyebrows Regrowth
34.5%
42.0%
23.5%
14.3%
52.4%
33.3%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Complete Regrowth Partial Regrowth No Regrowth
% of regrowth in eyebrows regrowth (total, % of n=119) and with
Intralesional triamcinolone (ILK, % of n=21)
Eyebrows total
Eyebrows ILK

9. Results: Eyelashes Regrowth
38.7%
30.3% 31.1%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Complete Regrowth Partial Regrowth No Regrowth
% of regrowth in eyelashes

10. Results: Combinations of Regrowth
Complete eyebrows and eyelashes and absent scalp growth 1 (0.8%)
Complete eyebrows, eyelashes, and partial scalp growth 19 (16.0%)
Complete eyebrows, eyelashes and complete scalp growth 19 (16.0%)
Partial eyebrows, eyelashes, and scalp growth 43 (36.1%)

11. Summary
• Severe scalp hair loss often predicts eyebrows and/or
eyelashes involvement
• When there is more than one hair-bearing site involved, all of
the hair-bearing sites do not necessarily respond similarly to
treatment, i.e. scalp hair may regrow without regrowth of
eyebrows and/or eyelashes and vice versa
• Although regrowth of scalp hair is uncommon in AA with
complete or near-complete scalp hair loss of >10 years
duration, eyebrows and eyelashes in these patients may
respond (completely) to treatment.

12. Acknowledgments
My patients
My nurse: Cara Esposito
My wife and collaborator: Britt Craiglow
The scientists: Angela Christiano & Raphael Clynes
Support: The Ranjini and Ajay Poddar Resource Fund for
Dermatologic Diseases Research

13. Thank you
brett.king@yale.edu