Comparative Efficacy of Oral Janus Kinase Inhibitors and Biologics in Adult Alopecia Areata: A Systematic Review and Bayesian Network Meta-Analysis

This study systematically reviewed and conducted a Bayesian network meta-analysis to compare the efficacy of oral Janus kinase (JAK) inhibitors and biologics in treating alopecia areata (AA). The analysis included randomized trials reporting outcomes using the Severity of Alopecia Tool (SALT). Baricitinib_4 mg showed the highest probability of being the most effective treatment, followed by ritlecitinib_200_50 mg and ivarmacitinib_4 mg. In contrast, dupilumab, secukinumab, tralokinumab, and apremilast were less effective. The study highlights the potential of targeting the JAK signaling pathway for hair regrowth, noting that JAK inhibitors like baricitinib and ritlecitinib exhibit dose-dependent efficacy, unlike ivarmacitinib. Further research is needed to understand the distinct mechanisms of these JAK inhibitors.