The Current State of Patient Adherence to Lab Monitoring Guidelines for Janus Kinase Inhibitors in Patients with Alopecia Areata.

Background: While Janus kinase inhibitors (JAKi) show excellent outcomes in Phase2b/3 trials for alopecia areata (AA), they do have potential side effects due to their immunosuppressive nature and other effects on the JAK-STAT pathway. These side effects can be mitigated by adherence to lab monitoring.

Objective: The authors sought to analyze patients, using JAKi, to manage symptoms of AA, to determine frequency of lab monitoring and check for adherence to the recommended rate of every three months.

Methods: A retrospective chart review was conducted by first identifying all patients diagnosed with AA at a specialty hair clinic in an academic dermatology department between January 2021 and May 2024. Each patient chart was reviewed for past and current use of any known oral JAKi. Fifty-seven patients were identified to meet our inclusion criteria and all of their charts were reviewed. The primary outcome is the average time between lab monitoring dates for each patient. The hypothesis was formulated after the data collection in the form of whether patients were being adherent to lab monitoring protocol.

Results: Most patients were non-adherent to the lab testing frequency standard. Significant differences were found in blood test times between adherent and non-adherent patients and between non-adherent and extremely non-adherent patients with p-values less than 0.01 for both sets.

Conclusion: Patients with AA undergoing JAKi treatment are not adhering to the recommended lab monitoring frequency. New tactics to improve adherence need to be taken.