Efficacy and safety of baricitinib in patients with refractory alopecia areata

Wang, Yuqian; Liu, Taoming; Li, Sheng; Tang, Sha; Lin, Pei-Yi; Ding, Yu; Sun, Qingguo; Zhu, Dexi; Qiao, Jianjun; Fang, Hong

doi:10.1111/dth.15845

Cited by 9 publications

(11 citation statements)

References 9 publications

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“…Recently, Wang et al. [ 21 ], reported a case series of 11 patients with AA, including two participants under the age of 18 years, treated with baricitinib for 20 weeks. Complete remission was achieved in two patients, while three patients, including one of the adolescents, did not respond to therapy at all.…”

Section: Discussionmentioning

confidence: 99%

Alopecia Universalis in an Adolescent Successfully Treated with Upadacitinib—A Case Report and Review of the Literature on the Use of JAK Inhibitors in Pediatric Alopecia Areata

Kołcz

Żychowska

Sawińska

et al. 2023

Dermatol Ther (Heidelb)

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Alopecia areata (AA) is a cell-mediated autoimmune disease in which a cytotoxic T-cell response against hair follicles occurs. AA has been demonstrated to frequently co-exist with atopic dermatitis (AD), and the coincidence of atopy predisposes to a more severe course of the disease. To date, therapeutic options in AA, especially in the pediatric population, are mainly limited to corticosteroids, irritants, sensitizers, and immunosuppressive agents. Recently, innovative therapies have emerged, among which Janus kinase (JAK) inhibitors, effective in both AD and AA, appear to be the most promising. Here, a 14-year-old girl with alopecia universalis (AU) and mild AD is demonstrated, who was successfully treated with a selective JAK1 inhibitor, upadacitinib, which has been approved for the treatment of AD in adults and children aged 12 years and older. Resolution of eczema and complete hair regrowth was achieved after 3 months of therapy. Apart from transient mild leukopenia at weeks 4 and 8, no adverse events were noted. Data in the literature on the efficacy and safety of JAK inhibitors in the treatment of AA in the pediatric population is based on single case reports and case series. So far, topical tofacitinib and ruxolitinib, as well as systemic tofacitinib, ruxolitinib, and baricitinib have been used off-label in this indication in children. Upadacitinib is another effective treatment option with a good benefit–risk ratio for patients with AA, including cases coexisting with AD.

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Section: Discussionmentioning

confidence: 99%

Alopecia Universalis in an Adolescent Successfully Treated with Upadacitinib—A Case Report and Review of the Literature on the Use of JAK Inhibitors in Pediatric Alopecia Areata

Kołcz

Żychowska

Sawińska

et al. 2023

Dermatol Ther (Heidelb)

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“…4 In a recent study, 11 patients with refractory AA were treated with baricitinib (JAK1/2 inhibitor), and 27% of patients achieved SALT 50 with twice-daily oral baricitinib (2 mg dose). 5 These successful attempts suggest that JAK inhibitors can be used in refractory AA, and have achieved good results.…”

Section: Effective Treatment Of Refractory Alopecia Areata In Pediatr...mentioning

confidence: 99%

Effective treatment of refractory alopecia areata in pediatric patients with oral abrocitinib

Huang

Liu

2023

J of Cosmetic Dermatology

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severe atopic dermatitis. JAK1 is involved in the signaling of γc receptor cytokines (IL-2, IL-4, IL-7, IL-9, IL-15, and IL-21) and IFNγ. 3 These cytokines are the main key factors in the pathogenesis of AA, so we use abrocitinib to treat AA, probably because it covers the cytokines in AA pathophysiology.This case suggests that axitinib may be an alternative treatment for children with refractory AA who fail to respond to conventional therapy. Further prospective studies are needed to evaluate its efficacy and safety.

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“…Other researchers also observed various shrinking of the alopecia area after weeks 12 and 24 in both adult 17,18 and pediatric patients. 19 However, the SALT value at week 4 was not significantly inferior to baseline, indicating that a minimum treatment duration of more…”

Section: Discussionmentioning

confidence: 76%

“…Besides, in our study, the hair restoration level observed at week 24 was superior to that of week 12 with a statistical difference. Other researchers also observed various shrinking of the alopecia area after weeks 12 and 24 in both adult 17,18 and pediatric patients 19 . However, the SALT value at week 4 was not significantly inferior to baseline, indicating that a minimum treatment duration of more than 12 weeks was required to determine whether a patient had a response to baricitinib.…”

Section: Discussionmentioning

confidence: 88%

Effectiveness and safety of baricitinib in patients with moderate‐to‐severe refractory alopecia areata in real world: An open‐label, single‐center study

Bi,

Wang,

et al. 2023

J of Cosmetic Dermatology

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PurposeBaricitinib is a small‐molecular drug that selectively inhibits the Janus Kinase (JAK) 1 and 2. However, it showed various efficiency and safety in treating moderate‐to‐severe alopecia areata (AA). This study was to describe the real‐world effectiveness of baricitinib in treating moderate‐to‐severe refractory AA.MethodsPatients who were affected by moderate‐to‐severe AA and reported no shrinkage in the alopecia area after 6 months of conventional treatment were enrolled in the retrospective study. The patients were treated with baricitinib orally for at least 24 weeks. The severity of alopecia was evaluated at the end of 4, 12, and 24 weeks of treatment.ResultsThe 32 patients included 23 females and nine males, with a median duration of AA of 14.5 months. Among them, 28 patients received baricitinib 2 mg per day for 24 weeks while the other four patients increased the daily dose from 2 to 4 mg after the first 12 weeks due to the unobvious hair restoration. SALT value showed a significant decrease from baseline at week 12 and 24 (64.45 [44.68–100.00] vs. 26.80 [13.40–62.32], p < 0.0001 and 64.45 [44.68–100] vs. 9.40 [4.85–34.95], p < 0.0001). After 24 weeks of treatment, 50% of patients had an improvement of ≥2 points in IGA scores from the baseline, and IGA scores of 68.75% of patients were less than 2.ConclusionThis 24‐week research showed that baricitinib had favorable clinical efficacy and safety in treating moderate‐to‐severe AA, which is worthy of attention and expectation.

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Efficacy and safety of baricitinib in patients with refractory alopecia areata

Cited by 9 publications

References 9 publications

Alopecia Universalis in an Adolescent Successfully Treated with Upadacitinib—A Case Report and Review of the Literature on the Use of JAK Inhibitors in Pediatric Alopecia Areata

Alopecia Universalis in an Adolescent Successfully Treated with Upadacitinib—A Case Report and Review of the Literature on the Use of JAK Inhibitors in Pediatric Alopecia Areata

Effective treatment of refractory alopecia areata in pediatric patients with oral abrocitinib

Effectiveness and safety of baricitinib in patients with moderate‐to‐severe refractory alopecia areata in real world: An open‐label, single‐center study

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