Treatment Response to JAK Inhibitors in Long-standing Alopecia Areata (≥8 Years): A Real-world Observational Study

This study evaluated the efficacy and safety of JAK inhibitors (baricitinib, tofacitinib, or ritlecitinib) in 31 patients with long-standing alopecia areata (≥8 years). The mean age of participants was 24.6 years, with an average episode duration of 12.7 years. At week 24, 27.6% of patients achieved a SALT score ≤20, and 24.1% achieved a score ≤10. Relative improvements were seen in 48.3% (SALT30), 31.0% (SALT50), and 24.1% (SALT80) of patients. However, 58.1% discontinued treatment, mainly due to lack of efficacy. Common adverse events included folliculitis (22.6%) and acne (12.9%). Despite limited overall response, some patients experienced significant hair regrowth, suggesting JAK inhibitors as a viable treatment option for this condition.