- Design
- Phase 2, randomised, dose comparison
- Population
- 57 adults with severe alopecia areata
- Primary outcome
- Relative change in SALT score at week 24
- Effect
- 46.4% (90% CI 34.3–58.4) with 8 mg twice daily vs 18.0% (7.6–28.4) with 16 mg once daily
This phase 2 trial, published in JAAD on 11 September, randomised 57 adults with severe alopecia areata to the JAK1/2 inhibitor deuruxolitinib, 8 mg twice daily or 16 mg once daily, the same total daily dose.
At 24 weeks the relative improvement in SALT score was 46.4% with twice-daily dosing against 18.0% once daily, and more patients on the twice-daily regimen reached SALT 20 or less and 10 or less. Adverse events were mild or moderate.
The lesson reaches beyond this drug: for a short-half-life JAK inhibitor, splitting the dose kept the effect in a way a single daily dose did not. The trial was small and had no placebo arm. Availability of deuruxolitinib in India is not known.
- If using deuruxolitinib, keep the twice-daily schedule; once-daily dosing regrew less hair here.
- Warn patients that missing the evening dose of a twice-daily JAK inhibitor may matter.
- Judge response at about six months; regrowth is slow.
- Monitor as for other JAK inhibitors, including blood counts, lipids and infection risk.
Why it matters
Patients often ask to take tablets once a day; for this drug, that cost most of the benefit.
Don't overread it
A 57-patient phase 2 trial without placebo; the estimates are imprecise.
The statistics, in plain English
The trial reported 90% confidence intervals (34.3 to 58.4 vs 7.6 to 28.4), which are narrower than the usual 95% intervals. They do not overlap, which suggests a real difference, but with 57 patients the size of it is uncertain.
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