Efficacy of Baricitinib in Patients with Various Degrees of Alopecia Areata Severity: Post-Hoc Analysis from BRAVE AA1 and BRAVE AA2

Susan Taylor; Neil J Korman; Tsen-Fang Tsai; Yutaka Shimomura; Meghan Feely; Yves Dutronc; Wen-Shuo Wu; Najwa Somani; Antonella Tosti

doi:10.1007/s13555-023-01033-8

Efficacy of Baricitinib in Patients with Various Degrees of Alopecia Areata Severity: Post-Hoc Analysis from BRAVE AA1 and BRAVE AA2

Dermatol Ther (Heidelb). 2023 Dec;13(12):3181-3191. doi: 10.1007/s13555-023-01033-8. Epub 2023 Sep 23.

Authors

Susan Taylor¹, Neil J Korman², Tsen-Fang Tsai³, Yutaka Shimomura⁴, Meghan Feely^{5

6}, Yves Dutronc⁵, Wen-Shuo Wu⁵, Najwa Somani⁵, Antonella Tosti⁷

Affiliations

¹ Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
² University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
³ Department of Dermatology, National Taiwan University Hospital & National Taiwan University College of Medicine, Taipei, Taiwan.
⁴ Department of Dermatology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
⁵ Eli Lilly and Company, Indianapolis, IN, USA.
⁶ Department of Dermatology, Mount Sinai, New York, NY, USA.
⁷ Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, FL, USA. atosti@med.miami.edu.

Abstract

Background: Baricitinib, an oral selective JAK1/JAK2 inhibitor, is approved for the treatment of adults with severe alopecia areata (AA).

Objective: To evaluate differences in response up to week 52 among subgroups based on the baseline severity of AA assessed with the Severity of Alopecia Tool (SALT) score.

Methods: Data were pooled from BRAVE-AA1 and BRAVE-AA2, two randomized, placebo-controlled, phase 3 trials, which enrolled adults with a SALT score ≥ 50. Patients were subdivided by the degree of AA severity at baseline.

Results: Among the 855 patients treated with baricitinib 2 mg and 4 mg, improvements in scalp hair growth continued through to week 52. A superior response was observed in patients with a SALT score of 50-94 versus a score of 95-100. Patients on baricitinib 4 mg had a faster and higher response rate compared to baricitinib 2 mg.

Conclusion: Across all degrees of severity for baricitinib 2 mg and 4 mg doses, the proportion of patients responding was yet to plateau up to week 52. Response to treatment was longer for patients with a baseline SALT score 95-100. Further studies are needed to analyze other parameters that may impact observed response rates.

Keywords: Adults; Alopecia areata; Alopecia totalis; Alopecia universalis; Baricitinib; Clinician-reported outcome; Efficacy; Hair loss; Janus kinase; Randomized; Severity of alopecia tool.