Safety of Janus Kinase Inhibitors in Patients with Alopecia Areata: A Systematic Review

This systematic review analyzed the safety of Janus kinase (JAK) inhibitors in patients with alopecia areata, following PRISMA guidelines and searching PubMed, Scopus, and EBSCO databases until March 13, 2023. A total of 36 studies were included. The review found that the most common side effects of JAK inhibitors were headache and acne. Specifically, baricitinib was associated with hypercholesterolemia (18.2% vs 10.5%, odds ratio [OR] = 1.9) and headache (6.1% vs 5.1%, OR = 1.2), brepocitinib with elevated creatinine levels (27.7% vs 4.3%, OR = 8.6) and acne (10.6% vs 4.3%, OR = 2.7), ritlecitinib with acne (10.4% vs 4.3%, OR = 2.6) and headache (12.5% vs 10.6%, OR = 1.2), and deuruxolitinib with headache (21.4% vs 9.1%, OR = 2.7) and acne (13.6% vs 4.5%, OR = 3.3). The OR for upper respiratory tract infections ranged from 7.3 with deuruxolitinib to 1.0 with baricitinib and ritlecitinib, indicating a variable risk. The review concluded that the risk of serious adverse events with JAK inhibitors in alopecia areata patients was not increased.