Background: The search for effective treatment of Alopecia areata is ongoing. In the recent years JAK inhibitors and Calcipotriol have emerged as two promising treatment modalities.

Objective: To evaluate and compare the therapeutic efficacy of tofacitinib cream (2%) and calcipotriolointment (0.005%) in the treatment of alopecia areata. 

Methods: A total of 100 alopecia areata patients were enrolled. All the patients were thoroughly examined for severity of disease using SALT scores and were randomized to receive either 2% Tofacitinib cream (n=50; mean age 28.44 years; 44% urban residents; 82% multiple patches) or 0.005% Calcipotriol ointment (n=50; mean age 26.26 years; 50% males; 84% multiple patches). Followed up was done at 4 weekly intervals upto 16 weeks. Data was statistically analyzed. Data was statistically analyzed.

Results: At baseline the two groups had a comparable demographic and clinical profile. Mean SALT scores were 21.66±2.25 and 20.43±3.98 respectively in Tofacitinib and Calcipotriol groups. Significant reductions in mean SALT scores were observed from the first follow-up itself. At the last follow-up, mean reduction in SALT scores was 11.82±2.15 (53.65%) in Tofacitinib and 5.40±1.36 (26.41%) in Calcipotriolgroup. At all the follow-up intervals, mean SALT scores were significantly lower in Tofacitinib as compared to that in Calcipotriol group. Complete response rate was better in Tofacitinib than in Calcipotriol group. No major adverse effect was noted. There was no significant difference between two groups with respect to adverse drug reactions at any of the follow-up intervals.

Conclusion: Tofacitinib was a better alternative than Calcipotriol.