Prescription Pattern of Tofacitinib for Alopecia Areata Among the Dermatologists in Saudi Arabia: A Cross-Sectional Study

Introduction Alopecia areata (AA) is a complex autoimmune condition that causes nonscarring hair loss. In Saudi Arabia, AA accounts for 1-2% of new dermatological outpatient visits. It typically presents with sharply demarcated round patches of hair loss and may present at any age. Traditional medical therapies include corticosteroids and immunotherapy. Choosing the ideal treatment depends on multiple factors such as patient age, disease severity, efficacy, side effects, and remission rate. Recent medications that have been used for treating AA are Janus kinase inhibitors. Aim The aim of the study is to assess the awareness and attitude of dermatologists and their use of Tofacitinib in treating AA. Method A cross-sectional study was conducted in 2019 across 14 major cities in Saudi Arabia. A self-administered online questionnaire was specifically developed and used. Dermatologists from government hospitals and private clinics were included through non-probability convenience sampling. The collected data was entered into Microsoft Excel and analyzed using SPSS program version 24. Results In total, out of 546 Dermatologists across Saudi Arabia who responded to the questionnaire, 127 (23.2%) physicians prescribed Tofacitinib in their practice. Out of those who prescribed the drug for AA cases, 58 dermatologists (45.6%) prescribed Tofacitinib after the failure of steroid injections. Among the 127 dermatologists who have utilized Tofacitinib in their practice, 92 (72.4%) believe that Tofacitinib is effective in treating AA. Almost 200 (47.7%) Dermatologists who never prescribed Tofacitinib reported that the main reason was due to the unavailability of the drug in the clinic they were practicing. Conclusions To conclude, out of 546 dermatologists working in Saudi Arabia, 127 (23.2%) prescribe Tofacitinib to treat AA. Ninety-two (72.4%) of the participants reported the effectiveness of Tofacitinib. Two hundred (47.7%) dermatologists who never prescribe Tofacitinib reported that the main reason was due to the unavailability. However, this would raise the need for more research regarding JAK inhibitors generally and Tofacitinib specifically, focusing on the effectiveness versus the side effects of Tofacitinib.