BH19 'JAK in the Box?' Long-Term Safety Concerns with Oral Janus Kinase Inhibitors for Alopecia Areata

Janus kinase (JAK) inhibitors show promise for treating alopecia areata (AA) by promoting hair regrowth, but their long-term safety remains uncertain due to their broad immunomodulatory effects. A review of 15 clinical trials revealed that while JAK inhibitors are generally well tolerated with mild to moderate adverse events (AEs) like upper-respiratory-tract infections, acne, and headache, serious AEs such as malignancies and cardiovascular events were rare. The longest study, the ALLEGRO trial on ritlecitinib, extended to 2 years, but most had follow-ups of 52 weeks or less. Despite favorable short-term safety profiles, the lack of long-term data necessitates further research to assess risks associated with chronic use, emphasizing the need for cautious clinical application and informed patient decisions.