The Future of Tailored Alopecia Treatment

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In consideration of emerging JAK inhibitor options, and the current prescribing availability of baricitinib.

Baricitinib, the first therapy approved to treat hair loss in patients with alopecia areata, was a long time coming for dermatologists and clinicians previously without a single option for impacted patients.

Now that it’s here, new standards for care are being sought—and these clinicians now must consider the next hurdles of prescribing and tailoring treatment.

In the final segment of an interview with HCPLive during the 2022 Fall Clinical Dermatology Meeting this week, Brett King, MD, PhD, associate professor of dermatology at Yale School of Medicine, discussed the ongoing evaluation of not only baricitinib, but fellow JAK inhibitors for alopecia areata. What does he see as key differences in outcomes for what could be a competitive drug class for the patient population?

King believes there’s more similarities than differences among agents thus far, though future data may distinguish one from another for a select patient.

“But it’s truly provocative when you understand that baricitinib, ritlecitinib, deuruxolotiinib—3 distinctively different JAK inhibitors, in clinical trials in which primary endpoints are measured at 24-36 weeks—the drugs across multiple doses are showing efficacy in the 30-40% of patients rate, which is fascinating,” he said. “It kind of makes you wonder if there’s a ceiling to what we can do with JAK inhibitors.”

At the same time, other systemic therapy options outside the JAK inhibitor class are in development for treating alopecia areata—a necessary step toward broadening the scope of available care for the chronic condition. “Time will help” experts understand how baricitinib will particularly benefit patients across the spectrum of alopecia severity and duration of disease, King explained.

On the subject of prescribing and treatment availability for baricitinib, King said the process has been so far, so good since its approval in June.

“There’s also important work that needs to be done in understand and documenting improvement in quality of life when re-growing hair,” King said. “All of us who do this don’t spend a second thinking there’s not a dramatic impact on quality of life when we can restore normalcy, but it’s hard to measure. So there’s a lot of work that needs to be done here, and it’s sort of what makes this evolving story so fun.”