Effectiveness and safety of baricitinib in severe alopecia areata: 48‐week results

作者：Bianca Maria Piraccini, Stephano Cedirian, Francesca Pampaloni, Luca Rapparini, Federico Quadrelli, Francesca Bruni, Lorenzo Ala, Maria Cristina Acri, Alfredo Rossi, Giovanni Pellacani, Francesco Lacarrubba, Federica Dall’Oglio, Giuseppe Micali, Luciano Foggia, Mariateresa Cantelli, Paola Nappa, Laura Diluvio, Luca Bianchi, Naldi Luigi, Anna Bolzon, Ketty Peris, Giacomo Caldarola, Giampiero Girolomoni, Francesca Marangoni, Francesco Bellinato, Paolo Gisondi, G Silvi, Francesca Prignano, Nicola Pimpinelli, Carlo Tomasini, Stefania Barruscotti, Oriana Simonetti, Edoardo De Simoni, Francesca Ambrogio, Caterina Foti, Valeria Boccaletti, Alessandro Fraghì, Angelo Valerio Marzano, Maria Alessandra Mattioli, Silvia Mariel Ferrucci, Andrea Sechi, Luca Valtellini, Mauro Barbareschi, Giuseppe Gallo, Simone Ribero, Pietro Quaglino, Isotta Giunipero di Corteranzo, Riccardo Balestri, Calogero Pagliarello, Raffaele Dante Caposiena, Iris Zalaudek, Emanuele Vagnozzi, Maria Concetta Fargnoli, Chiara Caponio, Pietro Rubegni, Élisa Cinotti, Emanuele Trovato, Marco Romanelli, Valentina Dini, Flavia Manzo Margiotta, Claudio Feliciani, Maria Beatrice De Felici Del Giudice, Laura Atzori, Silvia Sanna, Serena Lembo, Annunziata Raimondo, Michela Magnano, Giuseppe Argenziano, Graziella Babino, Elisabetta Fulgione, Franco Rongioletti, Nazario Pesce, Stefania Guida, Alba Guglielmo, Natale Schettini, Michela Starace · 发表于：Journal of the European Academy of Dermatology and Venereology · 年份：2025 · DOI：10.1111/jdv.70067 · 被引用次数：7 · 研究领域：Hair Growth and Disorders、Dermatology and Skin Diseases、Facial Rejuvenation and Surgery Techniques

BACKGROUND: Alopecia areata (AA) is an autoimmune condition leading to hair loss. Baricitinib, a Janus kinase (JAK) inhibitor, has demonstrated efficacy in controlled clinical trials, but real-world data on its long-term effectiveness and safety remain limited. OBJECTIVES: This study aimed to assess the real-life effectiveness and safety of baricitinib 4 mg daily in Italian adult patients with severe AA over a 48-week treatment period. METHODS: We conducted a 48-week retrospective, observational, multicenter study across 27 Italian university hospitals. Adult patients (18-65 years) with severe AA (Severity of Alopecia Tool [SALT] score ≥ 50) who initiated baricitinib 4 mg daily treatment between November 2022 and October 2023 were included. Effectiveness was measured by the percentage of patients achieving SALT ≤20 at week 48. Secondary outcomes included changes in mean SALT score, trichoscopic findings, patient-reported quality of life (Skindex-16, Hospital Anxiety and Depression Scale [HADS]), and Clinician-Reported Outcomes (ClinRO) for eyebrows and eyelashes. Adverse events were also documented. RESULTS: A total of 253 patients (66.8% females, mean age 40.0 ± 12.6 years) were included. By week 48, 63.2% achieved SALT ≤20, and 75.5% achieved SALT ≤30. The mean SALT score significantly decreased from 93.7 ± 14.1 at baseline to 26.5 ± 33.0 at week 48 (p < 0.001). Trichoscopic assessment showed a decline in yellow dots (97.6%-50.2%), black dots (43.5%-9.1%), and dystrophic ha...