Real-world Effectiveness and Safety of Janus Kinase Inhibitors in Alopecia Areata: A Retrospective Cohort Study of 72 Patients
DOI:
https://doi.org/10.2340/actadv.v105.42990Keywords:
Alopecia areata, Janus Kinase Inhibitors, Real world evidence, Safety, Treatment OutcomeAbstract
Alopecia areata (AA) is an autoimmune hair loss disorder characterized by sudden hair shedding due to immune dysregulation involving the Janus Kinase – Signal Transducer and Activator of Transcription (JAK-STAT) pathway. JAK inhibitors (JAKi) have demonstrated efficacy in clinical trials, but data from real-world settings remain scarce. This retrospective, single-centre cohort study evaluated the real-world effectiveness and safety of JAKi (abrocitinib, baricitinib, ritlecitinib, upadacitinib, and tofacitinib) in 72 patients treated between December 2017 and February 2024. Patients had a mean age of 34 years and a mean disease duration of 8 years. At time points 3, 6, 9, 12, and 18 months substantial regrowth was observed in 18 (25%), 28 (38.9%), 25 (34.7%), 22 (30.6%), and 19 (26.4%) patients respectively. Over a median follow-up of 16 months, 61% achieved substantial regrowth at a median time of 7 months. At 3, 6, 9, and 12 months, the cumulative regrowth rates were 11.1%, 40.2%, 55.6%, and 59.7%, respectively. Among non-responders who switched medications, 75% achieved substantial regrowth. Two serious adverse events occurred (sickle cell crisis and renal failure with pre-existing dysfunction). The findings indicate that JAKi are effective and safe for AA treatment in real-world settings. Further prospective studies are necessary to optimize treatment guidelines.
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