Safety and efficacy of baricitinib in severe alopecia areata patients

A recent study found that in patients with severe alopecia areata (AA), baricitinib demonstrated a high level of efficacy maintenance for a duration of 104 weeks. The effectiveness notably escalated in Week-52 mixed responders, underscoring the significance of long-term treatment needed to observe the maximum benefit in certain patients. This study’s results were published in the Journal of the European Academy of Dermatology and Venereology.

Data from the BRAVE-AA1 and BRAVE-AA2 Phase 3 trials was integrated, involving adults with Severity of Alopecia Tool (SALT) scores of 50 or higher (indicating ≥50% scalp hair loss) who were randomly assigned to receive and consistently take either 2-mg or 4-mg baricitinib up to Week 104. Patients who were eligible to continue receiving treatment were those who had a SALT score of ≤20 at Week 52 [N=65, 2-mg dose; N=129, 4-mg dose; Week-52 responders]. Additionally, patients who received the 4-mg dose and initially had a SALT score >20 at Week 52 but achieved SALT score ≤20 at previous visits and/or had significant improvement in eyebrow or eyelash hair growth compared to their baseline by Week 52 were also considered for continuous treatment [N=110; Week-52 mixed responders]. The Week-104 outcomes were assessed based on the proportion of patients who achieved a SALT score of ≤20 (indicating ≤20% scalp hair loss).

At Week 104, 90.7% of patients treated with 4 mg of baricitinib and 89.2% of those treated with 2 mg of baricitinib who responded positively at Week 52 maintained a SALT score of ≤20. Among the mixed responders at Week 52, 39.1% achieved a SALT score of ≤20 by Week 104. Enhanced eyelash and eyebrow regrowth was consistently noted in every group.

Thus, it can be concluded that over a duration of 104 weeks, baricitinib showcased a remarkable ability to maintain efficacy in patients with severe AA. Notably, Week-52 mixed responders experienced an increase in efficacy, emphasizing the necessity of long-term treatment to observe the maximum benefits in specific individuals.