Comparative Efficacy and Safety of Baricitinib Against Traditional Therapies in Severe Alopecia Areata: A Retrospective Cohort Study

This retrospective cohort study evaluated the efficacy and safety of baricitinib, a JAK inhibitor, compared to traditional therapies for severe alopecia areata (AA) over 6 months, involving 75 patients. Baricitinib showed promising results, with a significant number of patients achieving a SALT score ≤20, indicating ≤20% scalp hair loss, and outperforming other therapies in hair regrowth. Approximately 30% of baricitinib patients achieved a SALT score ≤20, and nearly 50% reached SALT50, with 26% achieving SALT90. However, baricitinib was associated with adverse effects, including serum lipid elevations in nearly 50% of patients and short-lasting infections in 25%. The study supports baricitinib as a viable treatment for severe AA, though further research is needed to confirm these findings.