VIDEO: Treatment benefit in alopecia areata wanes with down titration of baricitinib
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NEW ORLEANS — In this Healio exclusive video, Brett King, MD, PhD, discusses data indicating that down titration of baricitinib after 52 weeks may not be the optimal treatment strategy for patients with alopecia areata.
The findings by King, associate professor of dermatology at Yale University School of Medicine in New Haven, Connecticut, and colleagues were presented at the American Academy of Dermatology Annual Meeting.
In the randomized, double-blind, placebo-controlled, down-titration substudy of the BRAVE-AA2 trial, those taking baricitinib 4 mg who achieved a Severity of Alopecia Tool score of 20 or less at 52 weeks and continued this treatment rather than down titrating to 2 mg experienced better results, according to King.
“The reason this is such an important question about what happens is that the label for baricitinib says that for regrowth achieved with 4 mg, change the dose to 2 mg,” King said.
In doing this, King and colleagues observed 52% of patients lose response over the next 52 weeks.
“This is hazardous,” King said. “It’s like this data is screaming at us: ‘Don’t do that!’”
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King B, et al. Outcomes of down-titration in patients with severe scalp alopecia areata treated with baricitinib 4 mg: Week 104 data from BRAVE-AA2. Presented at: American Academy of Dermatology Annual Meeting; March 17-21, 2023; New Orleans.
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