Effectiveness and Safety of Tofacitinib in Patients With Recalcitrant Frontal Fibrosing Alopecia : A Pilot Study
- Conditions
- Lichen PlanopilarisFrontal Fibrosing Alopecia
- Interventions
- Registration Number
- NCT06202560
- Lead Sponsor
- Institute of Dermatology, Thailand
- Brief Summary
The goal of this study is to study the efficacy and safety of Tofacitinib therapy in Thai patients with recalcitrant frontal fibrosing alopecia.
The main questions are
1. Does Tofacitinib significantly reduce Frontal Fibrosing Alopecia Severity Index (FFASI), Frontal Fibrosing Alopecia Severity Score (FFASS), Lichen planopillaris Activity Index (LPPAI) compared to baseline and after 16 weeks?
2. Is Tofacitinib significantly different for adverse events compared to baseline and after 16 weeks? Participants will have a check-up in clinical and investigation and then get prescribed oral Tofacitinib 5 mg twice a day for 12 weeks. After that, they will have follow-up every 4 weeks until week 16.
- Detailed Description
1.The researcher collects personal data including age, gender, weight, height, body mass index, waist circumference, personal medical history, history of medication use in the past 3 months (menstruation history for female subjects), as well as records of symptoms such as hair loss history and diagnosis, pattern of hair loss on the scalp or other areas, comorbidities, family history, and other accompanying symptoms.
2.The researchers require the patients to undergo various blood tests before receiving treatment.
3. The researchers collect data on the patients' skin conditions using Digital Camera and a Dermoscope. They capture images of the scalp, eyebrows, eyelashes, facial rashes, joint folds, arms, legs, nails, mouth, and dark spots (if present).
4.Participants in the research will receive oral Tofacitinib medication with a dosage of 5 mg, twice a day, for 12 weeks. They will be scheduled to come for follow-up every 4 weeks throughout the 12-week period, and will continue to be followed up for 4 weeks after stopping the medication. The total duration of the research will be 16 weeks. The purpose is to evaluate the effectiveness and safety of the medication.
1. The symptoms of the disease to be assessed include facial papule, LP pigmentosus, pruritus, trichodynia, perifollicular erythema, and perifollicular hyperkeratosis.
2. Frontal Fibrosing Alopecia Severity Index (FFASI)
3. Frontal Fibrosing Alopecia Severity Score (FFASS)
4. Lichen Planopillaris Activity Index (LPPAI)
5. The photograph will be taken. The areas photographed include the scalp, eyebrows, eyelashes, facial rashes, joint folds, arms, legs, nails, dark spots (if present), and mouth. Two expert physicians will evaluate the photographs independently, and the photographs of 10 patients were assessed to determine the consistency among the physicians before evaluating the actual patients. The evaluation will determine whether the patient's conditions have improved, remained stable, or worsened.
6. Dermoscopy will be performed. The areas examined include the scalp, eyebrows, eyelashes, facial rashes, joint folds, arms, legs, nails, dark spots (if present), and mouth.
7. The patient's abnormal symptoms after medication administration will be evaluated, including respiratory tract infections, skin abnormalities, gastrointestinal abnormalities, urinary tract infections, or other symptoms.
8. Laboratory tests will be conducted to assess the safety of the medication at weeks 4, 12, and 16.
Recruitment & Eligibility
- Status
- ENROLLING_BY_INVITATION
- Sex
- All
- Target Recruitment
- 11
-
Thai males or females who were at least 18 years old
-
Participants who were diagnosed with frontal fibrosing alopecia The criteria for the diagnosis of frontal fibrosis alopecia are 2 major criteria or 1 major criterion plus 2 minor criteria. (Vañó-Galván et al., 2014)
-
Participants who were diagnosed with recalcitrant frontal fibrosing alopecia
- The patient who fails treatment of at least one drug, such as hydroxychloroquine, and/or receives others, such as immunosuppressive drugs, pioglitazone, and retinoids. However, the symptoms of FFA still appear, such as perifollicular erythematous and/or scale, after taking treatment for more than 3 months
- The patient continued taking the medicine as prescribed and coming to follow-up
- The patient still has the medical record, such as a picture and dermoscopy
- The patient does not need a washout time from the current medicine
- Patients who were diagnosed with a disease that may relate to hair growth within six months, such as thyroid disease, iron deficiency anemia, liver disease, heart disease, neurological system disease, gastroenteritis disease, sexual disease, cancer, and psychologic disease
- Pregnancy
- Patients who have contraindications to take oral Tofacitinib such as severe infection, allergy to Tofacitinib, venous thromboembolism, leukopenia, severe liver disease, severe kidney failure, pneumonia, cancer
- Patients who received strong or moderate to strong CYP3A4 agents
- Patients who had positive on HBsAg and/or HCV
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Tofacitinib Tofacitinib 5 MG taking oral Tofacitinib 5 mg twice a day for 12 weeks
- Primary Outcome Measures
Name Time Method Effectiveness of oral tofacitinib in recalcitrant Frontal Fibrosing Alopecia(FFA) 16 weeks after taking oral Tofacitinib The effectiveness of this study will be evaluated by comparing the Frontal Fibrosing Alopecia Severity Index (FFASI) (Max score = 100 and Min score = 0), Frontal Fibrosing Alopecia Severity Score (FFASS) (Max score = 25 and Min score = 0), and Lichen Planopilaris Activity Index (LPPAI) (Max score = 10 and Min score = 0) between week 0 (baseline week) and week 16. If a patient has a lower score on all of these indices, it means the treatment is more effective. In addition, two expert physicians will independently evaluate the photographs. The two evaluators will determine whether the patient's conditions have improved, remained stable, or worsened.
- Secondary Outcome Measures
Name Time Method Clinical & Investigation Safety of oral tofacitinib in recalcitrant (FFA) 16 weeks after taking oral Tofacitinib The safety of clinical and laboratory investigation and oral Tofacitinib treatment is evident, as patients do not experience any complaints of abnormal symptoms after taking the drugs. These symptoms may include respiratory tract infections, skin abnormalities, gastrointestinal abnormalities, urinary tract infections, or other adverse events at weeks 4, 12, and 16.
Trial Locations
- Locations (1)
Hair and Nail center, Institute of Dermatology
🇹🇭Bangkok, Thailand