Alopecia Areata in Skin of Color Patients: New Considerations Sparked by the Approval of Baricitinib

The paper discusses the impact of the first FDA-approved medication for alopecia areata (AA), baricitinib, a Janus kinase (JAK) inhibitor. AA is an autoimmune genetic disease causing relapsing and remitting nonscarring hair loss, with patients reporting lower health-related quality of life scores compared to other skin conditions. The paper highlights the need for real-world outcomes and considerations for different races and ethnicities. The two phase 3 trials for baricitinib included Black and Latino patients, but not in a representative way. Recent studies suggest an increased prevalence of AA in Black patients in the US, raising concerns about access to care and treatment. The phase 3 trials for baricitinib, BRAVE-AA1 (N=654) and BRAVE-AA2 (N=546), showed 33% of patients achieved 80% or more scalp coverage at 36 weeks. However, of the total 1200 patients, only 98 identified as Black, indicating a need for more diversified study participants. Other treatments, such as ritlecitinib, brepocitinib, and deuruxolitinib, are also on the horizon.