D3.248 - Prospective Evaluation Of The Efficacy Of Janus Kinase Inhibitor Therapy In Children With Alopecia Areata And Atopic Dermatitis

AA is a common disease with a significant impact on quality of life, especially affecting patients with AA associated with AD. The aim of our study was to investigate the therapeutic efficacy and dynamics of life quality in children with alopecia areata (AA) and atopic dermatitis (AD) receiving systemic monotherapy with the Janus kinase inhibitor tofacitinib compared to combination therapy with corticosteroids and local narrow-band 311 nm phototherapy.

Two groups of children (2 to 17 y o) with 15 participants in each group suffering from AA and AD with a SALT score ≥20 and SCORAD ≥20, were formed. The first group (I) received combination therapy with corticosteroids and local phototherapy, the second (II) - monotherapy with tofacitinib at a dose of 10 mg/day. Assessment using the SALT scale, the Children's Dermatology Life Quality Index (CDLQI) and SCORAD was performed at baseline and at 16 weeks. The median, 1st and 3rd quartiles were calculated for the parameters. Comparison of indicators was performed using the Kruskal-Wallis test. Changes were considered significant at p≤0.05.

At baseline participants in the group I had a median SALT score of 60 (Q1 – 35; Q3 – 92), SCORAD - 40 (Q1 – 25; Q3 – 80). The median CDLQI was 6 (Q1 – 2; Q3 – 8). Participants in the group II had a median SALT score of 53 (Q1 – 35; Q3 – 90), SCORAD 45 (Q1 – 30; Q3 – 70). The median CDLQI was 8 (Q1 – 5; Q3 – 11).

After 16 weeks of therapy: in the group I the median SALT score was 36 (22; 55), p=0.0212, SCORAD 20 (10, 30), p=0.002; in the group II, the median SALT score was 48 (32; 75), SCORAD 45 (28, 60). No significant differences were found compared to week 0 (p=0.1978) for SALT score and no significant differences for SCORAD (p=0.867).

At week 16 the median CDLQI in group I was 3 (1; 6). Assessment of this indicator compared to baseline showed significant differences (p=0.0334). Evaluation of the CDLQI in group II at week 16 yielded a median value of 4 (2; 8), which also demonstrated a significant improvement in the life quality index (p=0.0035). No adverse events were observed during the study in any of the groups.

Tofacitinib monotherapy demonstrates greater efficacy compared to topical corticosteroid therapy and local narrow-band phototherapy 311 nm in patients with AA and AD.