Janus Kinase Inhibitors Versus Other Biological Treatments in Alopecia Areata

The document discussed the complexity of treating alopecia areata (AA) due to the intricate interactions between T cells and hair follicles. Traditional treatments targeting Th1 cells, such as ustekinumab, have not been effective, suggesting that Th1 cells may not be the primary drivers of AA. Recent findings indicated that cytotoxic CD8(+)NKG2D(+) T cells might be responsible for AA, with Janus kinase (JAK) inhibitors showing promise in reversing AA symptoms. Studies on JAK inhibitors like ruxolitinib, tofacitinib, and baricitinib demonstrated their potential effectiveness, although their safety in AA patients remains to be fully established. Additionally, fontolizumab, an anti-IFN-γ, emerged as a potential treatment, warranting further research.