Janus Kinase Inhibitors for Alopecia Areata

August 2023 in “ Journal of the American Academy of Dermatology ”

Brett King, Brittany G. Craiglow

Janus kinase inhibitors alopecia areata JAK inhibitors baricitinib ritlecitinib deuruxolitinib scalp hair loss Phase 3 clinical trials AA

From the encyclopedia

Alopecia Areata →

autoimmune disorder causing patchy hair loss

Baricitinib →

JAK inhibitor that reduces inflammation and immune attacks on hair follicles, leading to potential hair regrowth, especially in alopecia areata cases

Studysummary This source reports that the approval of baricitinib and ritlecitinib, which are JAK inhibitors, has marked a significant advancement in treating severe alopecia areata (AA), and suggests that additional treatments with new mechanisms may further improve patient outcomes in the future.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

Janus kinase (JAK) inhibitors have significantly advanced the treatment of moderate-to-severe alopecia areata (AA), a condition that has been difficult to treat historically. The approval of baricitinib and ritlecitinib, with deuruxolitinib nearing approval, highlights this progress. Phase 3 clinical trials demonstrated that baricitinib resulted in ≤20% scalp hair loss in 39% and 23% of patients at 4 mg and 2 mg doses, respectively, over 36 weeks. Ritlecitinib showed similar results in 23% of patients at 50 mg over 24 weeks, increasing to 40% over 48 weeks, while deuruxolitinib showed 30%-42% efficacy over 24 weeks. These results emphasize the potential of JAK inhibitors in managing AA, although topical JAK inhibitors have not been effective for moderate-to-severe cases.

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Research cited in this study

6 / 6 results

research Two Phase 3 Trials of Baricitinib for Alopecia Areata

148 citations , March 2022 in “The New England Journal of Medicine”

In two phase 3 trials, this study found that oral baricitinib significantly improved hair regrowth compared to placebo in adults with severe alopecia areata after 36 weeks, though longer trials are needed to ascertain its long-term efficacy and safety.

Utility of Azathioprine, Methotrexate, and Cyclosporine as Steroid-Sparing Agents in Chronic Alopecia Areata: A Retrospective Study of Continuation Rates in 138 Patients

research Utility of Azathioprine, Methotrexate, and Cyclosporine as Steroid-Sparing Agents in Chronic Alopecia Areata: A Retrospective Study of Continuation Rates in 138 Patients

12 citations , August 2020 in “JEADV. Journal of the European Academy of Dermatology and Venereology/Journal of the European Academy of Dermatology and Venereology”

This study found that most chronic alopecia areata patients treated with azathioprine, methotrexate, or cyclosporine continued treatment for at least 12 months, often requiring concurrent low-dose prednisolone.

research Combination Tofacitinib and Oral Minoxidil Treatment for Severe Alopecia Areata

23 citations , September 2019 in “Journal of The American Academy of Dermatology”

In this retrospective analysis, combination therapy with tofacitinib and oral minoxidil led to significant scalp hair regrowth in patients with severe alopecia areata, with 67% achieving at least 75% regrowth, although the small sample size limits the findings.

research Tofacitinib 2% Ointment, a Topical Janus Kinase Inhibitor, for the Treatment of Alopecia Areata: A Pilot Study of 10 Patients

48 citations , November 2017 in “Journal of the American Academy of Dermatology”

Tofacitinib 2% ointment helped hair regrow in 3 out of 10 patients with alopecia areata, but caused side effects like scalp irritation and raised cholesterol in some.

research Killing Two Birds with One Stone: Oral Tofacitinib Reverses Alopecia Universalis in a Patient with Plaque Psoriasis

185 citations , June 2014 in “Journal of Investigative Dermatology”

This case report describes complete hair regrowth in a patient with alopecia universalis and improved psoriasis after treatment with the oral Janus kinase inhibitor, tofacitinib.

research Lymphocytes, Neuropeptides, And Genes Involved In Alopecia Areata

286 citations , August 2007 in “Journal of Clinical Investigation”

This review examines the interplay of genetics and neuroimmunology in alopecia areata, highlighting its potential to inform broader autoimmunity research, but reports no new findings.