Long-term therapy Baricitinib improves hair growth in severe alopecia areata

A new study published in the American Journal of Clinical Dermatology suggests that Baricitinib's effectiveness for treating people with severe alopecia areata (AA) increased over the course of 52 weeks, suggesting that long-term therapy may be required to see the most therapeutic benefit. 

An autoimmune condition known as alopecia areata results in patchy hair loss on the face, scalp, and body. Baricitinib, an oral JAK inhibitor, has been effective for treating severe alopecia areata over a period of 36 weeks. On the longer-term management of AA, there is less information. For this reason, 52 weeks of continuous treatment in two phase III studies were used to examine the effectiveness and safety of baricitinib for AA in people with less than 50% scalp hair loss (BRAVE-AA1 and BRAVE-AA2).

Participants in BRAVE-AA1 (N = 465) and BRAVE-AA2 (N = 390) who were initially randomized to receive baricitinib continued to receive it until Week 52. The percentage of patients who achieved a Severity of Alopecia Tool (SALT) score under 20 (less than 20% scalp hair loss) was one measure of efficacy. Due to the coronavirus disease 2019 (COVID-19) pandemic, data were suppressed after permanent treatment termination or if gathered remotely.

The key findings of this study were:

During the course of the 52-week period, response rates for hair regrowth rose. 

In Week 52, 40.9% and 21.2% of patients receiving baricitinib 4 mg and 2 mg, respectively, and 36.8% and 24.4% of patients receiving BRAVE-AA2 treatment, respectively, had a SALT score of 20 or below. 

Upper respiratory tract infection, urinary tract infection, nasopharyngitis, headache, acne, creatine phosphokinase elevation, and COVID-19 infection were the most common treatment-emergent side events. 

Long-term therapy outcomes show that hair regrowth for people with severe AA receiving baricitinib continues to improve without any new safety concerns. There were no more warning signs.

Reference: 

Kwon, O., Senna, M. M., Sinclair, R., Ito, T., Dutronc, Y., Lin, C.-Y., Yu, G., Chiasserini, C., McCollam, J., Wu, W.-S., & King, B. (2023). Efficacy and Safety of Baricitinib in Patients with Severe Alopecia Areata over 52 Weeks of Continuous Therapy in Two Phase III Trials (BRAVE-AA1 and BRAVE-AA2). In American Journal of Clinical Dermatology. Springer Science and Business Media LLC. https://doi.org/10.1007/s40257-023-00764-w