Efficacy and Safety of the Oral Janus Kinase Inhibitor Baricitinib in the Treatment of Adults with Alopecia Areata: Phase 2 Results from a Randomized Controlled Study

The study assessed the effectiveness and safety of baricitinib, an oral Janus kinase inhibitor, in 110 adults with severe alopecia areata. Patients were randomized to receive either a placebo or baricitinib at doses of 1 mg, 2 mg, or 4 mg daily. The 1 mg dose was discontinued due to lower efficacy. At week 36, 33.3% of patients in the 2 mg group and 51.9% in the 4 mg group achieved a Severity of Alopecia Tool (SALT) score of ≤20, significantly more than the 3.6% in the placebo group. The study also found significant improvements in Clinician-Reported Outcome measures for scalp, eyebrow, and eyelash hair loss with baricitinib. Safety outcomes were acceptable, with no serious adverse events or deaths. Despite the small sample size, the study concluded that baricitinib is effective and safe for treating alopecia areata, warranting further phase 3 trials.