Efficacy and Tolerability of Brevilin-A, a Natural JAK Inhibitor, in Pediatric Alopecia Areata: A Case Series

Enrico Matteini,1,* Laura Diluvio,1,* Sara Lambiase,1 Arnaldo Cioni,1 Ruslana Gaeta Shumak,1 Gaetana Costanza,2 Caterina Lanna,1 Giacomo Caldarola,3,4 Luca Bianchi,1 Elena Campione1 1Dermatology Unit, Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy; 2Department of Experimental Medicine, University of Rome ”Tor Vergata”, Rome, Italy; 3UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy; 4Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy*These authors contributed equally to this workCorrespondence: Laura Diluvio, Dermatology Unit, Department of Systems Medicine, University of Rome “Tor Vergata”, Viale Oxford 81, Rome, 00133, Italy, Tel +39 06 20902743, Fax +39 06 20902742, Email [email protected]: Alopecia areata represents an autoimmune disease that specifically damages growing hair follicles on the scalp and/or around the body. Janus kinase inhibitors have been identified as an effective therapy in adult patients and topical formulations, such as Brevilin-A, might represent a well-tolerated treatment for mild-moderate disease in children and adolescents. The mechanism of action of Brevilin-A, a sesquiterpene lactone isolated from Centipeda minima, could consist in blocking STAT3 and STAT1 signaling as well as the JAKs activity by inhibiting the JAKs tyrosine kinase domain JH1. We report our cases of successful application of Brevilin-A in pediatric patients, suggesting this treatment as a safe and effective therapeutic option also for recalcitrant alopecia areata in pediatric population.Keywords: alopecia areata, brevelin A, pediatric, topical JAK inhibitors