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Two JAK Inhibitors Appear to Be Safe and Effective for Alopecia Areata 27th European Academy of Dermatology and Venereology Congress 12–16 SEPTEMBER 2018 • PARIS, FRANCE By the PracticeUpdate Editorial Team

confidence intervals, in which missing val- ues are treated as nonresponse. A total of 142 patients (n=98 women [69%]) were enrolled: 47 received placebo, 48 received PF-06651600, and 47 received PF-06700841. A total of 62 (44%) patients suffered from alopecia totalis, 42 (30%) from alopecia universalis. Overall, 92 patients (65%) had no or mini- mal eyelashes, 16 (11%) a moderate number of eyelashes, 94 (66%) no or minimal eye- brows, and 26 (18%) moderate eyebrow involvement. At baseline, the mean patient age was 36 ± 13 years. Median duration of current disease was 2 (0.2–30) years, and mean total score on the Severity of Alopecia Tool was 88.1 ± 17.3. At week 24, both JAK inhibitors were asso- ciated with a significant placebo-adjusted mean change from baseline in score on the Severity of Alopecia Tool (PF-06651600: 33.6 [95% confidence interval 21.4, 45.7], P < .001; PF-06700841: 49.5 [95% confi- dence interval 37.1, 61.8], P < .001). Statistically significant separation from placebo was observed at weeks 6 and 4, as well as greater improvement in the PF-06700841 group. Compared with placebo, both JAK inhibitors were associated with significantly greater

Six months of treatment with either agent was efficacious, safe, and well tolerated. I ncluding patients with alopecia totalis and universalis, 24 weeks of treatment with the Janus kinase (JAK) 3 inhibitor PF-06651600 or the JAK1/tyrosine kinase 2 inhibitor PF-06700841 have been found to be efficacious, safe, and well tolerated for moderate to severe alopecia areata. This finding of an ongoing phase IIa, ran- domized, double-blind, multicenter study was reported at EADV 2018. Rodney Daniel Sinclair, MD, of the Univer- sity of Melbourne, Victoria, Australia, and colleagues set out to evaluate the efficacy, safety, and tolerability of PF-06651600 and PF-06700841 in patients with moderate to severe alopecia areata. Patients aged 18–75 years with chronic (>6 months) moderate to severe (affecting >50% of the scalp) alopecia areata were randomized 1:1:1 to placebo or: • PF-06651600 (200 mg once daily for 4 weeks, followed by 50 mg once daily for 20 weeks), or

• PF-06700841 (60 mg once daily for 4 weeks, followed by 30 mg once daily for 20 weeks) The primary efficacy endpoint was mean change from baseline score on the Sever- ity of Alopecia Tool at week 24. Secondary endpoints included the pro- portion of participants who achieved 30%, 50%, 75%, 90%, and 100% improvement from baseline score on the Severity of Alo- pecia Tool. The proportion of eyelash and eyebrow responders in terms of one grade of improvement on the respective assess- ment scale (range 0–3) was also assessed among patients with the condition at baseline. Safety and tolerability assessments included adverse events and laboratory measurements. Mean change from baseline to week 24 in score on the Severity of Alopecia Tool was analyzed using a mixed-effects model with repeated measures. Binary endpoints were assessed as two-sample proportions using Chan and Zhang’s exact unconditional method for

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