Comparative Efficacy and Safety of Systemic Steroids, Oral JAK Inhibitors, and Contact Immunotherapy in the Treatment of Severe Alopecia Areata: A Systematic Review and Network Meta-Analysis

July 2024 in “ Archives of Dermatological Research ”

Ruixuan Guan, Yiling Lin, Cun Zhang, Zhao Wang, Zhiping Wu, Xiaojing Liu, Xin Chen, Yongjun Piao

alopecia areata systemic steroids oral JAK inhibitors contact immunotherapy dexamethasone diphenylcyclopropenone ritlecitinib baricitinib DPCP

TLDR Oral ritlecitinib and baricitinib are promising treatments for severe alopecia areata due to their balance of effectiveness and safety.

This systematic review and network meta-analysis assessed treatments for severe alopecia areata, finding oral dexamethasone and diphenylcyclopropenone (DPCP) to be the most effective, with SUCRA rankings of 95.9% and 74.5%, respectively. However, oral ritlecitinib was deemed safer, with a safety ranking of 86.5%, due to more manageable adverse events. Despite the high efficacy of dexamethasone and DPCP, their adverse effects were often intolerable, making oral ritlecitinib and baricitinib promising future treatments due to their balance of efficacy and safety.

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Research cited in this study

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research Long-Term Efficacy and Safety of Baricitinib in Patients With Severe Alopecia Areata: 104-Week Results From BRAVE-AA1 and BRAVE-AA2

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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

research 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

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Baricitinib is effective and safe for treating severe alopecia areata.

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research A Phase 2a Randomized, Placebo-Controlled Study to Evaluate the Efficacy and Safety of the Oral Janus Kinase Inhibitors Ritlecitinib and Brepocitinib in Alopecia Areata: 24-Week Results

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research The Changing Landscape of Alopecia Areata: The Therapeutic Paradigm

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New treatments for Alopecia Areata, like JAK inhibitors, show promise for hair regrowth and are likely to change future treatment approaches.

Diphencyprone and Topical Tacrolimus as Two Topical Immunotherapeutic Modalities: Are They Effective in the Treatment of Alopecia Areata Among Egyptian Patients? A Study Using CD4, CD8, and MHC II as Markers

research Diphencyprone and Topical Tacrolimus as Two Topical Immunotherapeutic Modalities: Are They Effective in the Treatment of Alopecia Areata Among Egyptian Patients? A Study Using CD4, CD8, and MHC II as Markers

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