Switching JAK Inhibitors: Evaluating Baricitinib’s Effectiveness in Alopecia Areata After Tofacitinib Failure

This retrospective study evaluated the effectiveness of baricitinib in 26 alopecia areata (AA) patients who did not respond adequately to tofacitinib. The study found that switching to baricitinib led to a significant reduction in the SALT score from 68 ± 31 to 50 ± 31 over approximately 7 months, compared to a reduction from 90 ± 19 to 68 ± 31 over 16 months with tofacitinib. Notably, 66.66% of patients who did not respond to tofacitinib showed improvement with baricitinib, and 60% of patients with Alopecia Universalis experienced eyebrow and eyelash regrowth. Baricitinib was also effective in pediatric cases and had fewer mild adverse effects (3.84%) compared to tofacitinib (30.76%). The study concludes that baricitinib is a safe and effective alternative for AA patients who do not respond to tofacitinib, though further research is needed to confirm these findings.