Short-Term Malignancy Risk of JAK Inhibitors in Severe Alopecia Areata: A Multicenter Cohort Study

This retrospective cohort study investigated the malignancy risk associated with Janus kinase inhibitors (JAKis) in patients with severe alopecia areata (AA) using data from the TriNetX Global Collaborative Network. The study included 920 patients treated with traditional immunosuppressants and 920 treated with JAKis, with a mean follow-up of approximately 3.5 years. The results showed no significant difference in the risk of squamous cell carcinoma/basal cell carcinoma between the two groups. However, the risk of internal and hematologic malignancies was significantly higher in patients treated with traditional immunosuppressants compared to those treated with JAKis. Additionally, no significant difference in malignancy risk was observed between 446 JAKi-treated and 446 untreated patients. These findings suggest that JAKis do not increase malignancy risk in AA, aligning with previous meta-analyses in autoimmune diseases. However, due to the study's retrospective nature and limited follow-up, longer-term studies are needed to fully understand the long-term safety of JAKis in AA.