Efficacy and Safety of Tofacitinib in Paediatric Alopecia Aerata - A Prospective Observational Study

Background: Alopecia areata (AA) is an autoimmune condition marked by non-scarring hair loss. Materials and Method: In this prospective observational study, we enrolled 50 pediatric patients with moderate-to-severe alopecia areata. Participants received oral tofacitinib for 24 weeks. Clinical efficacy was assessed using the Severity of Alopecia Tool (SALT) score. Secondary outcomes included time to hair regrowth, patient/parent satisfaction, and Paediatric Quality of Life Inventory (PedsQL) scores. Result: Forty-five participants completed the 24-week study. A significant decrease in SALT score from baseline (mean 66.2 ± 8.1) to week 24 (mean 25.7 ± 9.2) was observed (P < 0.001). Complete or near-complete hair regrowth was achieved in 42.2% of patients, with partial regrowth in 37.8%. Conclusion: Tofacitinib demonstrated a favorable risk–benefit profile for treating moderate-to-severe pediatric alopecia areata over 24 weeks. These findings support the potential of JAK inhibitors as a therapeutic option in children with recalcitrant disease, although long-term safety and relapse rates warrant further investigation.