Clinical Benefits of Baricitinib Therapy in Patients With Severe Alopecia Areata

According to a study published in Dermatology and Therapy, significant regrowth in eyebrow and eyelash hair can occur despite an absence of complete scalp hair regrowth after treatment with baricitinib.

Researchers combined results from BRAVE-AA1 and BRAVE-AA2 clinical trials, investigating the impact of baricitinib treatment on scalp hair regrowth over 52 weeks. The study focused on patients receiving continuous treatment with baricitinib at doses of 4 mg or 2 mg. Clinical outcomes were evaluated using the Severity of Alopecia Tool (SALT) and Clinician-Reported Outcome (for Eyebrow (EB) Hair Loss and Eyelash (EL) Hair Loss. Secondary measures included assessments of anxiety, depression, and quality of life adapted for alopecia areata. Patients were classified at week 52 into 3 groups: those achieving a SALT ≤ 20 response, intermediate response (30% improvement from baseline without reaching SALT30), or nonresponse.

The results indicated that with baricitinib 4 mg treatment, the most substantial improvement (70%) in EB and EL hair regrowth occurred in responders. However, even among intermediate responders (30% improvement without reaching SALT30) and nonresponders, about 50% and 20%, respectively, experienced complete or nearly complete regrowth of EB and EL hair. Emotional distress improvement was linked to enhancements in scalp hair regrowth, and quality of life impact was more pronounced in the responder subgroup.

“Emotional distress and quality of life improvement is most associated with obtaining a clinical meaningful improvement in scalp hair,” the authors concluded.

Reference
Senna MM, Kwon O, Piraccini BM, et al. Clinical benefits of baricitinib therapy according to scalp hair regrowth in patients with severe alopecia areata. Dermatol Ther (Heidelb). Published online November 22, 2023. doi:10.1007/s13555-023-01063-2