Eyebrow, eyelash regrowth precedes scalp regrowth with baricitinib treatment for alopecia

Patients with alopecia areata who were treated with baricitinib experienced improvement in eyebrow and eyelash growth before scalp hair regrowth, according to a poster presented at AAD VMX 2021.

“Alopecia areata (AA) is an autoimmune disorder associated with hair loss, poor quality of life and psychological comorbidities,” Maryanne M. Senna, MD, of Massachusetts General Hospital in Boston, and colleagues wrote. “Baricitinib, an oral, reversible and selective Janus kinase (JAK)1/JAK2 inhibitor, is approved for the treatment of adults with moderately to severely active rheumatoid arthritis and is indicated for the treatment of moderate to severe atopic dermatitis in Europe and Japan in adults who are candidates for systemic therapy.”

The ongoing multicenter, randomized, double-blind, placebo-controlled phase 2/3 BRAVE-AA1 trial is evaluating baricitinib’s efficacy and safety in treating AA in patients with at least 50% scalp hair loss.

In patients treated with baricitinib 4 mg, 70% had a 30% or greater improvement in Severity of Alopecia Tool score, while 50% of those treated with a 2 mg dose experienced the same response. The median time to response was 36 weeks for both doses.

In the 4 mg dose cohort, an improvement of 1 or more points in eyebrow or eyelash clinician-reported outcome measures was reported in 83% of patients, with the median time to improvement being 15 weeks for eyebrows and 9 weeks for eyelashes. In the 2 mg cohort, 73% achieved an improvement of 1 or more points, with the median time to improvement being 12 weeks for both eyebrows and eyelashes.

“Preliminary results from phase 2 of BRAVE-AA1 suggest that noticeable improvements in eyebrow and eyelash scores with baricitinib may precede scalp hair regrowth in patients with AA,” the authors wrote. “Additional analyses from large phase 3 studies are necessary to confirm these initial results.”