Long-Term Real-World Outcomes of Baricitinib in Severe Alopecia Areata: A 104-Week Retrospective Analysis From a Single Institute

This study evaluated the long-term efficacy and safety of baricitinib, a Janus kinase inhibitor, in treating severe alopecia areata (AA) over 104 weeks. The retrospective analysis included 51 patients, with 36 continuing treatment for the full duration. Results showed that 55.6% of these patients achieved a SALT score of ≤20, and 72.2% experienced a ≥30% improvement in their SALT score from baseline. Key predictors of positive response included female sex and a disease duration of less than 4 years. Additionally, patients who showed eyebrow or eyelash regrowth at 52 weeks were more likely to achieve long-term scalp hair regrowth. The study also identified a subgroup of slow responders who achieved significant improvement between 52 and 104 weeks. Baricitinib was well tolerated, with no serious long-term adverse effects reported, supporting its efficacy and safety for long-term use in severe AA.