Real-Life Effectiveness and Tolerance of Baricitinib for the Treatment of Severe Alopecia Areata with 1-Year Follow-Up Data

    September 2023 in “Dermatology and Therapy
    Axel De Greef, Romane Thirion, Pierre‐Dominique Ghislain, Marie Baeck
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    TLDR Baricitinib effectively regrows hair in most people with severe alopecia, especially those with patchy hair loss, but hair may fall out again if treatment stops.
    A retrospective study of 19 adults with severe alopecia areata (AA) treated with baricitinib, an oral Janus kinase 1 and 2 inhibitor, over 13 months showed hair regrowth in nearly 90% of patients between 4 and 16 weeks after starting treatment. By the end of the follow-up, over 70% of patients, and specifically 100% of patients with patchy AA, achieved a Severity of Alopecia Tool (SALT) score of ≤ 20, indicating significant hair regrowth. Almost half of the patients, mostly with patchy AA, showed complete hair regrowth within a median treatment time of 8.5 months. However, baricitinib was discontinued in three patients who had total hair regrowth, two of whom relapsed. No serious adverse events were reported, with lipid changes being the most frequent adverse event. The study concluded that baricitinib is effective in treating AA, particularly the patchy phenotype, but there is a risk of relapse after discontinuation.
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