Patients with AA report high long-term regrowth rates with baricitinib

Patient-reported outcomes from 2 phase 3 clinical trials confirmed that baricitinib is an efficacious therapy for patients with severe alopecia areata (AA). After a year of follow-up, a larger proportion of participants reached a self-reported complete or nearly complete regrowth of scalp, eyebrow, or eyelash hair than at week 36. The 4 mg dose of baricitinib was associated with higher response rates than the 2 mg dose.

Baricitinib is an efficacious therapy for patients with severe AA, as shown by the results of 2 phase 3 trials [1]. “To gain a better view on the efficacy of this agent, we need to evaluate responses from the patient’s perspective,” argued Dr Maryanne Senna (Harvard Medical School, MA, USA) [2]. Dr Senna discussed patient-reported outcomes for scalp hair, eyebrow, and eyelash regrowth during 52 weeks of treatment with baricitinib, using findings from the BRAVE-AA1 (NCT03570749) and BRAVE-AA2 (NCT03899259) trials.

Both trials randomised participants with severe AA (n=654; n=546) 2:2:3 to placebo, 2 mg baricitinib daily, or 4 mg baricitinib daily. Of note, over 50% of the participants had 95–100% hair loss at baseline. Participants in the placebo arm were not included in the current analysis.

After 52 weeks, 35.3% and 19.1% of the participants in the 4 mg and 2 mg arms achieved a Scalp Hair Assessment PRO score of 0 or 1. At week 36, the corresponding rates were 33.7% and 16.0%, showing that regrowth of scalp hair increased in the long term. For the patient-reported outcome measure reporting on eyebrow regrowth, scores of 0 or 1 were reached by 33.8% of the patients in the 4 mg arm at week 36, increasing to 40.4% at week 52. For the 2 mg arm, the corresponding rates were 15.7% and 21.3%. Similar findings were reported for patient-reported eyelash regrowth (see Figure).

Figure: Proportion of patients achieving a patient-reported outcome score of 0 or 1 on eyelash regrowth through week 52 [2]

BARI, baricitinib; CI, confidence interval.

In summary, the proportion of patients reporting complete or nearly complete scalp hair, eyebrow, and eyelash regrowth continued to increase from week 36 to week 52 in patients with severe AA on baricitinib. The response rates were higher in the 4 mg arm than in the 2 mg arm.

1. King B, et al. N Engl J Med 2022;386:1687–1699.
2. Senna MM, et al. Patient reported outcomes for scalp, eyebrow, and eyelash involvement in patients with severe alopecia areata treated with baricitinib: 52-week results from two phase 3 clinical trials. Session Hair Disorders 1, WCD 2023, 3–8 July, Singapore, Singapore.