[Efficacy and safety of baricitinib treatment in alopecia areata: a retrospective analysis].

INTRODUCTION

Alopecia areata is an autoimmune disease presenting with non-scarring hair loss. In Hungary, the JAK inhibitors baricitinib and ritlecitinib are approved for the treatment of severe alopecia areata, with their efficacy supported by the results of multicenter clinical trials.

OBJECTIVE

We retrospectively evaluated the efficacy and safety of baricitinib therapy in patients treated for severe alopecia areata, as well as factors influencing hair regrowth.

METHOD: We analyzed demographic data, medical history, disease duration, and severity in patients with severe alopecia areata treated with baricitinib at the Department of Dermatology and Allergology, University of Szeged. Disease severity was assessed using the Severity of Alopecia Tool (SALT). We examined the time to initial and complete hair regrowth, and the proportion of patients achieving a SALT≤20 score at months 3, 6, 9, and 12 of treatment.

RESULTS

30 patients (20 women and 10 men) were included, with a mean age of 33 years (range 9-56). Clinical subtypes included patchy (n = 13), diffuse (n = 1), ophiasis (n = 2), alopecia totalis (n = 4), and alopecia universalis (n = 12) forms, with a mean baseline SALT score of 74. The mean follow-up duration was 14 months (range 3-24). Initial hair regrowth was observed after a mean of 4 months (range 1-15), and complete hair regrowth (n = 16) after a mean of 10 months (range 2-19) of therapy. A SALT≤20 score was achieved by 23% of patients after 3 months, 46% after 6 months, 46% after 9 months, and 63% after 12 months. Reported adverse events included laboratory abnormalities, headache, herpes simplex, acne, weight gain, and mild infections. Treatment was discontinued in 6 patients: due to pregnancy planning (n = 3), lack of efficacy (n = 1), mild side effects (n = 1), and loss to follow-up (n = 1).

CONCLUSION

Our findings support the efficacy of baricitinib in the treatment of severe alopecia areata. Hair regrowth was observed in a substantial proportion of patients as early as the 3. month of therapy, with further improvement by month 12. Adverse events were mostly mild, leading to treatment discontinuation in only one case. Baricitinib appears to be an effective and safe therapeutic option for severe alopecia areata. Orv Hetil. 2025; 166(49): 1943-1948.