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

ABSTRACT 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.