Baricitinib for the Treatment of Alopecia Areata

Baricitinib, a drug that inhibits the Janus kinase (JAK) pathway, has been found to be more effective than a placebo in promoting hair growth in adults with severe alopecia areata (AA) after 36 weeks of treatment. This was demonstrated in a phase 2 trial and two phase 3 trials, BRAVE-AA1 and BRAVE-AA2, which included 654 and 546 patients respectively. At week 36, 38.8% and 35.9% of patients in the baricitinib group achieved a Severity of Alopecia Tool (SALT) score of 20 or less, compared to 6.2% and 3.3% in the placebo group. The most common side effects were nausea, acne, and upper respiratory tract infection. As a result, the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA) have approved baricitinib for the treatment of adults with severe AA. However, the document concludes that longer trials are needed to determine the long-term efficacy and safety of Baricitinib in AA.