Baricitinib For Alopecia Areata

Alopecia areata is an immune response against hair follicles, causing hair loss. Current treatments include intralesional corticosteroid injections, topical immunotherapy, Minoxidil, Anthralin, hair transplants, and platelet-rich plasma therapy. Baricitinib, a Janus kinase (JAK) inhibitor approved for rheumatoid arthritis and atopic dermatitis, has been identified as a potential treatment for severe alopecia areata. It blocks JAK enzymes involved in immune signalling and inflammation, inhibiting the signals that cause hair loss and promoting hair regrowth. In June 2022, the FDA approved baricitinib as the first systematic treatment for alopecia areata. Two clinical trials showed that after 36 weeks, oral baricitinib outperformed a placebo in promoting hair growth in patients with severe alopecia areata. The proportion of participants achieving at least 80% scalp hair coverage at 36 weeks was 38.8% with 4-mg baricitinib, 22.8% with 2-mg baricitinib, and 6.2% with placebo in the first trial, and 35.9%, 19.4%, and 3.3%, respectively, in the second trial.