Effectiveness and safety of baricitinib in patients with moderate‐to‐severe refractory alopecia areata in real world: An open‐label, single‐center study

Abstract Purpose Baricitinib is a small‐molecular drug that selectively inhibits the Janus Kinase (JAK) 1 and 2. However, it showed various efficiency and safety in treating moderate‐to‐severe alopecia areata (AA). This study was to describe the real‐world effectiveness of baricitinib in treating moderate‐to‐severe refractory AA. Methods Patients who were affected by moderate‐to‐severe AA and reported no shrinkage in the alopecia area after 6 months of conventional treatment were enrolled in the retrospective study. The patients were treated with baricitinib orally for at least 24 weeks. The severity of alopecia was evaluated at the end of 4, 12, and 24 weeks of treatment. Results The 32 patients included 23 females and nine males, with a median duration of AA of 14.5 months. Among them, 28 patients received baricitinib 2 mg per day for 24 weeks while the other four patients increased the daily dose from 2 to 4 mg after the first 12 weeks due to the unobvious hair restoration. SALT value showed a significant decrease from baseline at week 12 and 24 (64.45 [44.68–100.00] vs. 26.80 [13.40–62.32], p < 0.0001 and 64.45 [44.68–100] vs. 9.40 [4.85–34.95], p < 0.0001). After 24 weeks of treatment, 50% of patients had an improvement of ≥2 points in IGA scores from the baseline, and IGA scores of 68.75% of patients were less than 2. Conclusion This 24‐week research showed that baricitinib had favorable clinical efficacy and safety in treating moderate‐to‐severe AA, which is worthy of attention and expectation.