6ER-014 Evaluation of baricitinib in paediatric patients with alopecia areata

<h3>Background and Importance</h3> Alopecia areata (AA) is a chronic immune-mediated disorder characterised by transient, non-scarring hair loss and preservation of the hair follicle. Its global prevalence is estimated at 2% and is even higher in children. Currently, there is no curative treatment. Therapeutic interventions have targeted pathways involving JAK/STAT signalling. The aim of the treatments is to block the immune system’s attack and stimulate hair regrowth. Since 2023, baricitinib has been approved in our country for adult patients with AA who have at least 50% of hair loss (Severity of Alopecia Tool score (SALT) 50) and have not responded to standard treatment (systemic corticoids or methotrexate). Treatment response is defined as a SALT ≤20 after 36 weeks of treatment. <h3>Aim and Objectives</h3> To retrospectively evaluate the efficacy of off-label baricitinib used in children with severe and refractory AA at a third-level paediatric hospital. <h3>Material and Methods</h3> We reviewed our patients’ clinical histories at baseline and followed-up their progress over time after starting baricitinib. We focused on efficacy using the SALT score, evaluated possible side effects and patients’ feedback. Patients were psychologically monitored given their age and condition. <h3>Results</h3> Since July 2023, 17 patients (seven boys/10 girls) have started baricitinib in our hospital. From those, 13 (76.47%) have had at least one follow-up visit. The average age was 12.2 years (SD 2.75) ranging from 8–17 years-old. Treatment time was on average 36.91 weeks (SD 13.23) ranging from 10.00 to 56.86 months. Seven patients (50%) achieved the defined treatment goal, three patients (21.4%) had an improvement but did not reach SALT 20, 2 patients (14.3%) did not experience any regrowth and two patients (14.3%) experienced a worsening of their condition. Overall, treatment was well-tolerated although six patients (42.86%) had abnormal laboratory results, including elevated cholesterol, bilirubin, LDH, ALP or GGT. It was observed that 10 patients (71.43%) were psychologically affected. <h3>Conclusion and Relevance</h3> Baricitinib has shown debatable results in our paediatric population with AA. However, some patients have shown satisfactory outcomes in a short period of time, with full recovery in certain cases. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest