Efficacy and Safety of Baricitinib in Patients With Alopecia Areata: A Real‐World Cohort Study

Background: Alopecia areata (AA) is a common autoimmune disorder. Janus kinase (JAK) inhibitors have demonstrated the ability for treating AA in clinical trials. Objective: We aimed to assess the efficacy and safety of baricitinib, a JAK 1/2 inhibitor, in patients with AA in real world experience. Methods: This is a retrospective study of patients with AA treated with baricitinib. The primary end point was the change in Severity of Alopecia Tool (SALT) score during treatment. Results: A total of 47 patients met inclusion criteria. At weeks 12 and 24, 47% and 53% achieved SALT 20, respectively. By the end of treatment (24–104 months), 78.7% achieved SALT 20. The overall SALT score improvement before and after treatment was 48.51 (±30.36), with a hair regrowth rate of 68.10% ± 35.45%. Patients with disease duration ≤ 4 years showed significantly greater SALT score improvement and shorter time to hair regrowth onset compared to those with > 4 years. At week 24, 85.2% and 90.4% achieved ClinRO scores of 0/1 for eyebrow and eyelash alopecia, respectively. Negative correlations were observed between disease duration and hair regrowth rate, a positive correlation was found between treatment duration and hair regrowth rate. Baricitinib was well tolerated with no serious adverse events. Conclusion: Baricitinib demonstrated efficacy in treating AA, alopecia totalis, and alopecia universalis, as well as eyebrow and eyelash alopecia, and should be considered a therapeutic option for these conditions.