Alopecia Areata: A Clinical Review of the Changing Landscape with Janus Kinase Inhibitors

Alopecia areata (AA) is a chronic autoimmune disease causing hair loss, impacting patients' mental health and quality of life. Since June 2022, Janus kinase inhibitors (JAKis) like baricitinib, ritlecitinib, and deuruxolitinib have been approved for severe AA, showing significant efficacy in clinical trials with many patients experiencing hair regrowth. The THRIVE-AA2, BRAVE-AA1, BRAVE-AA2, and ALLEGRO trials demonstrated the effectiveness and safety of these treatments, with most adverse events being mild or moderate. However, responses vary, and discontinuation often leads to relapse. Early intervention improves outcomes, and while challenges remain in predicting responses and ensuring sustained regrowth, JAKis represent a promising treatment option for severe AA.