Efficacy and Safety of Baricitinib in the Treatment of Severe Alopecia Areata in Pediatric Patients: Data from Real-Clinical Practice

INTRODUCTION: Alopecia areata (AA) is an autoimmune disorder with a higher prevalence in pediatric patients than adults, but treatment options remain limited. Baricitinib, a Janus kinase (JAK)-1/2 inhibitor, has shown efficacy in adults with severe AA, yet data on its use in pediatric patients are limited. METHODS: This study included pediatric patients (ages 2-18) with severe AA (Severity of Alopecia Tool [SALT] ≥50) treated with baricitinib for at least 3 months between January 2023 and October 2024. Demographics, SALT scores before and after treatment, and adverse events were collected. RESULTS: Thirty-three patients were included, with a mean age of 9.93 years and average disease duration of 23.44 months. Sixteen patients received 2 mg and 17 received 4 mg of baricitinib. At baseline, 54.5% had a SALT score above 90. After treatment, 45.5% of patients had a 50% reduction in their SALT score. The average treatment duration was 6.5 months. Adverse events included elevated ALT (n = 1), acne (n = 1), and upper respiratory infection (n = 1), with no serious adverse events. CONCLUSION: Baricitinib demonstrated clinical efficacy and good tolerance in pediatric patients with severe AA.