Why do patients stop tofactinib (Xeljanz)?

 Why do patients stop tofacintib?

Tofacintib is an immunosuppressant medication that has taken centre stage as a potential option to treat advanced alopecia areata. It's not a treatment for early stage disease, and not an option for young children. It is however, rising to find a place on the list of potential treatments in advanced alopecia areata and alopecia totalis. I have been using it in the clinic for a few years now.

We have limited safety data in alopecia areata patients. That' s not to say we don't have safety data. The drug has been used in treating rheumatoid arthritis for many years now. As hair specialists, we get a lot of our data from looking at these other specialties - where massive numbers of patients have been treated. 

A new study released today looks at reasons why patients with rheumatoid arthritis stop tofacitinib. Dr J Pope looked at data from 4867 patients using tofacitinib. 21 % stopped the drug because of side effects. 8.8 % stopped because of infections; 3.2 % because of cancer. 

These data are important and as dermatologist we need to keep our eyes on the rheumatology, oncology and other fields of medicine for realistic numbers on safety. To date, our largest studies of use of tofacintib in alopecia top 100 patients. Our numbers on safety, side effects do look quite good. Studies in other fields, where large numbers of patients have been studied, provide us with a clear picture on safety and how best to counsel our patients. 

Discontinuing Tofacitinib: Why do patients stop?

Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Whistler office at 604.283.1887

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