Proteomic Predictors of Baricitinib Response in Severe Alopecia Areata: CCL11 Flags a Refractory Phenotype

This study examined the efficacy of baricitinib in 74 Chinese patients with severe alopecia areata and identified proteomic predictors of treatment response. At week 36, 56.8% of patients experienced significant hair regrowth, while 32.4% were non-responders, often linked to longer disease duration and specific alopecia types. Non-responders showed a low proinflammatory profile, suggesting a chronic, treatment-resistant state. Plasma CCL11 levels were identified as a biomarker for predicting non-responsiveness, emphasizing its potential for guiding personalized treatment strategies. The findings underscore the importance of early intervention to prevent refractoriness and support using CCL11 in treatment planning.