Oral Tofacitinib for the Management of Moderate to Severe Alopecia Areata in Children and Adolescents: A Retrospective Study of 36 Patients

BACKGROUND: Oral tofacitinib shows promise for pediatric alopecia areata (AA), but more data on its efficacy and safety are needed. METHODS: We analyzed 36 patients aged ≤ 16 years with moderate to severe AA (SALT score > 20) who received at least 6 months of oral tofacitinib. RESULTS: SALT75 was achieved in 72.2% (26/36) and SALT100 in 52.8% (19/36) within 4.1 ± 1.7 and 6.7 ± 2.8 months, respectively; 27.8% (10/36) were non-responders. Nine patients had adverse events, with two requiring treatment discontinuation. CONCLUSION: Tofacitinib is effective for pediatric AA, with rapid regrowth in responders. The durability of benefit and need for long term maintenance therapy require further investigation.