Baricitinib Effectiveness in JAKi-Naïve and Tofacitinib-Exposed Patients: A Prospective Study in Alopecia Areata

This study evaluated the effectiveness of baricitinib in 44 patients with severe alopecia areata (AA), comparing those previously treated with tofacitinib to JAKi-naïve individuals. Results showed that baricitinib significantly reduced Severity of Alopecia Tool (SALT) scores in JAKi-naïve patients (p = 0.007), while no significant changes were observed in those previously exposed to tofacitinib. However, 75% of patients with residual disease after tofacitinib responded to baricitinib. Adverse event rates were similar across both groups. The study concludes that baricitinib is more effective in JAKi-naïve patients, and switching JAKi can be beneficial, though further research is needed due to the study's limited sample size and noncontrolled design.