Duration of current alopecia areata episode predicts the effectiveness of baricitinib in Japanese patients with alopecia areata: a single-center retrospective study

Abstract

Objectives: Baricitinib showed efficacy for alopecia areata (AA) in clinical trials, with real-world data supporting its short-term effectiveness. However, long-term data are limited. We assessed the effectiveness and safety of baricitinib in AA patients over one year and explored predictive factors.

Methods: We analyzed data from 27 AA patients treated with baricitinib at our hospital.

Results: The majority (81%) had alopecia universalis, with a mean baseline SALT score of 93.9. Disease duration was positively correlated with the current AA episode's duration and negatively with serum TARC levels. At 3, 6, 9, and 12 months, 3.8%, 19.2%, 37%, and 58% of patients achieved a SALT score ≤20, respectively. The duration of the current AA episode at initiating baricitinib was correlated positively with absolute SALT score at 6 and 9 months, and negatively with the reduction rate of SALT score at 6 and 9 months. A shorter duration of the current episode (<4 years) was associated with better improvement in SALT scores at 6, 9, and 12 months compared to longer durations (≥4 years).

Conclusions: Baricitinib proved effective and safe for severe AA patients. The duration of the current AA episode is a key predictor of treatment success, highlighting the importance of early intervention.

Keywords: Alopecia areata; JAK; JAK inhibitor; Janus kinase; baricitinib; real-world.