Use Of Oral Janus Kinase Inhibitors For The Treatment Of Severe Alopecia Areata: Narrative Review And Real-World Experience

Alopecia areata (AA) is an autoimmune hair loss condition that can range from patchy hair loss to total scalp or body hair loss in severe cases. The 'IFN-γ-IL-15 cytokine loop' contributes to the disease's persistence, leading to the use of Janus kinase inhibitors (JAKis) like baricitinib and ritlecitinib in Japan for severe AA. These inhibitors have shown effectiveness and tolerability, with 30%-40% of patients experiencing significant hair regrowth. However, about 30% of patients do not respond to treatment, and relapses can occur even during ongoing treatment. Current and planned clinical trials are exploring new medications and dosing regimens to address these challenges and improve outcomes for severe AA.