{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:52:36Z","timestamp":1787014356843,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T00:00:00Z","timestamp":1621296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Tofacitinib is a JAK1\/3 inhibitor used off\u2010label to treat alopecia areata (AA). Oral tofacitinib undergoes extensive hepatic metabolism and has numerous drug interactions and a half\u2010life of 3\u00a0hours necessitating twice daily dosing. Sublingual delivery bypasses hepatic first\u2010pass metabolism, which may provide pharmacokinetic benefits and reduce gastrointestinal side effects. We investigate sublingual tofacitinib as a novel form of administration in a cohort of treatment\u2010resistant patients. The objective of this work is to assess the efficacy and pharmacokinetics of sublingual tofacitinib in moderate\u2010to\u2010severe AA patients. An open\u2010label, roll\u2010over pilot clinical trial was conducted. Participants were recruited from a preceding trial. All responders (\u226550% reduction in Severity of Alopecia Tool [SALT] score, SALT50) in the preceding trial continued on the same treatment (cyclosporine\/placebo), whereas nonresponders rolled over to receive open\u2010label sublingual tofacitinib 5\u00a0mg twice daily for 12\u00a0weeks. Treatment response as reduction in SALT score after 12\u00a0weeks (low: 15\u201329%, medium: 30\u201349%, good: 50\u201375%, and high grade: 75\u2013100%) was measured. Pharmacokinetics was analyzed using liquid chromatography tandem mass spectrometry. Eighteen participants completed the trial. Total treatment response to tofacitinib was 37.5%. SALT50 was achieved in 12.5%. The mean improvement in SALT score was 15.57%. Mean maximum plasma concentration was 43.18\u00a0ng\/ml occurring after 1\u00a0hour. Elimination half\u2010life is estimated to be up to 11\u00a0hours. An estimated half\u2010life of up to 11\u00a0hours may be achieved with sublingual tofacitinib, which is significantly longer than the oral form and may facilitate daily dosing. Larger clinical trials are required to further characterize its pharmacokinetics and efficacy.<\/jats:p>","DOI":"10.1111\/ijd.15657","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T00:29:27Z","timestamp":1621384167000},"page":"1135-1139","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Sublingual tofacitinib for alopecia areata: a roll\u2010over pilot clinical trial and analysis of pharmacokinetics"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4530-9864","authenticated-orcid":false,"given":"Vivien Wai Yun","family":"Lai","sequence":"first","affiliation":[{"name":"Medicine Alfred Hospital Melbourne VIC Australia"},{"name":"Clinical Trials Sinclair Dermatology East Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laita","family":"Bokhari","sequence":"additional","affiliation":[{"name":"Clinical Trials Sinclair Dermatology East Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6751-1428","authenticated-orcid":false,"given":"Rodney","family":"Sinclair","sequence":"additional","affiliation":[{"name":"Clinical Trials Sinclair Dermatology East Melbourne VIC Australia"},{"name":"Dermatology Melbourne University Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajd.12941"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/09546634.2019.1654068"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.16858"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2019.04.053"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajd.12913"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.15937"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.130683"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.89776"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2019.04.053"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2003.09.032"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/jidsymp.2013.19"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40271-013-0036-x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2016.02.307"},{"key":"e_1_2_6_15_1","volume-title":"Safety trial finds risk of blood clots in the lungs and death with higher dose of tofacitinib (Xeljanz, Xeljanz XR) in rheumatoid arthritis patients","author":"FDA","year":"2019"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcph.734"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1124\/dmd.113.054940"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/psp.2013.22"}],"container-title":["International Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.15657","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ijd.15657","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.15657","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T19:09:54Z","timestamp":1693336194000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijd.15657"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,18]]},"references-count":17,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1111\/ijd.15657"],"URL":"https:\/\/doi.org\/10.1111\/ijd.15657","archive":["Portico"],"relation":{},"ISSN":["0011-9059","1365-4632"],"issn-type":[{"value":"0011-9059","type":"print"},{"value":"1365-4632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,18]]},"assertion":[{"value":"2020-07-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}