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 hairs (14.6%–4.3%), whilst regrowing hairs increased (7.1%–80.2%). Skindex-16 scores improved significantly (57.1 ± 25.0 to 30.0 ± 17.8, p < 0.001), as did HADS Anxiety (8.21 ± 9.38 to 4.62 ± 4.21, p < 0.001) and HADS Depression (6.36 ± 4.55 to 3.70 ± 4.11, p < 0.001). Adverse events were reported in 9.4% of patients. Conclusion: This real-world study confirms the effectiveness of baricitinib in achieving significant hair regrowth and improving psychological well-being in severe AA patients.
Effectiveness and safety of baricitinib in severe alopecia areata: 48-week results / Piraccini, B. M.; Cedirian, S.; Pampaloni, F.; Rapparini, L.; Quadrelli, F.; Bruni, F.; Ala, L.; Acri, M. C.; Rossi, A.; Pellacani, G.; Lacarrubba, F.; Dall'Oglio, F.; Micali, G.; Foggia, L.; Cantelli, M.; Nappa, P.; Diluvio, L.; Bianchi, L.; Luigi, N.; Bolzon, A.; Peris, K.; Caldarola, G.; Girolomoni, G.; Marangoni, F.; Bellinato, F.; Gisondi, P.; Silvi, G.; Prignano, F.; Pimpinelli, N.; Tomasini, C.; Barruscotti, S.; Simonetti, O.; De Simoni, E.; Ambrogio, F.; Foti, C.; Boccaletti, V.; Fraghi, A.; Marzano, A. V.; Mattioli, M. A.; Ferrucci, S.; Sechi, A.; Valtellini, L.; Barbareschi, M.; Gallo, G.; Ribero, S.; Quaglino, P.; Di Corteranzo, I. G.; Balestri, R.; Pagliarello, C.; Caposiena, R. D.; Zalaudek, I.; Vagnozzi, E.; Fargnoli, M. C.; Caponio, C.; Rubegni, P.; Cinotti, E.; Trovato, E.; Romanelli, M.; Dini, V.; Manzo Margiotta, F.; Feliciani, C.; De Felici Del Giudice, M. B.; Atzori, L.; Sanna, S.; Lembo, S.; Raimondo, A.; Magnano, M.; Argenziano, G.; Babino, G.; Fulgione, E.; Rongioletti, F.; Pesce, N.; Guida, S.; Guglielmo, A.; Schettini, N.; Starace, M.. - In: JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY. - ISSN 0926-9959. - (2025). [10.1111/jdv.70067]
Effectiveness and safety of baricitinib in severe alopecia areata: 48-week results
Cantelli M.Membro del Collaboration Group
;Gisondi P.Membro del Collaboration Group
;Tomasini C.Membro del Collaboration Group
;Pagliarello C.Membro del Collaboration Group
;Feliciani C.Supervision
;De Felici Del Giudice M. B.Membro del Collaboration Group
;Atzori L.Membro del Collaboration Group
;Sanna S.Membro del Collaboration Group
;Guida S.Membro del Collaboration Group
;
2025-01-01
Abstract
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 hairs (14.6%–4.3%), whilst regrowing hairs increased (7.1%–80.2%). Skindex-16 scores improved significantly (57.1 ± 25.0 to 30.0 ± 17.8, p < 0.001), as did HADS Anxiety (8.21 ± 9.38 to 4.62 ± 4.21, p < 0.001) and HADS Depression (6.36 ± 4.55 to 3.70 ± 4.11, p < 0.001). Adverse events were reported in 9.4% of patients. Conclusion: This real-world study confirms the effectiveness of baricitinib in achieving significant hair regrowth and improving psychological well-being in severe AA patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
