皮肤性病诊疗学杂志2025，Vol.32Issue(9)：637-642,6.DOI:10.3969/j.issn.1674-8468.2025.09.004
托法替布治疗中重度斑秃的回顾性分析
Retrospective analysis of tofacitinib in the treatment of moderate to severe alopecia areata
摘要
Abstract
Objective To analyze the efficacy and safety of tofacitinib in the treatment of mod-erate to severe alopecia areata.Methods A retrospective analysis was performed on 21 patients with alopecia areata,including 11 moderate cases and 10 severe cases,who were treated at the De-partment of Dermatology,Wuyi Hospital of Traditional Chinese Medicine,Jiangmen City,between October 2021 and March 2025.Patients were treated with oral tofacitinib(5 mg twice daily),top-ical 5％minoxidil tincture,and halometasone cream for six months.Subsequently,other treat-ments were administered until tofacitinib was discontinued or its dose was reduced to≤5 mg dai-ly.Efficacy was assessed using the severity of alopecia tool(SALT)and compared between mod-erate and severe groups.Adverse reactions were observed at the same time.Results After 6 months,14 cases received combined treatment,including glucocorticoids,Chinese medicine,a la-ser at low energy level,microneedle therapy and platelet-rich plasma therapy.Combined glucocor-ticoid therapy was administered in six cases.The time to dose reduction and discontinuation was 2～6 months.ALT scores were significantly reduced from baseline to 3 months,6 months,and the end of treatment(values:51.19±20.96 at baseline,31.33±17.08 at 3 months,5.95±5.75 at 6 months,4.09±2.71 at end of treatment.t=10.92,10.65,and 9.77,respectively.P＜0.01 for all).The SALT scores were reduced from baseline by 42.68±12.22％at 3 months,86.76±7.52％at 6 months,and 92.24±4.34％at the end of treatment.The severe group ex-hibited a significantly lower rate of reduction in SALT scores at 3 months compared to the moderate group(Z=-2.01,P＜0.05).No significant intergroup differences were observed at the 6-month or end of the observation period.Treatment duration differed significantly between the groups,with a longer median duration in the severe group[9 months(IQR 8.5～14)]than in the moderate group[4 months(IQR 4～7)](Z=-3.34,P＜0.01).No serious adverse reac-tions were reported during treatment.Conclusions Tofacitinib is effective for moderate and se-vere alopecia areata and is well-tolerated.However,treatment response is slower in patients with severe alopecia areata,requiring a longer course of therapy.关键词
斑秃/JAK抑制剂/托法替布/SALT评分/微针/回顾分析Key words
alopecia areata/jak inhibitor/tofacitinib/salt score/microneedle therapy/restrospective analysis引用本文复制引用
王福军,付丽淼,蒋琪,于文沛,阳忠辉,冯全娣,马常青,钟鸣..托法替布治疗中重度斑秃的回顾性分析[J].皮肤性病诊疗学杂志,2025,32(9):637-642,6.基金项目
江门市医疗卫生领域科技计划项目(2022YL03013 （）
2024YL02010) （）
