Arash Mostaghimi, MD, MPH

A panelist discusses how they address the psychosocial aspects of alopecia areata by establishing a supportive doctor-patient relationship, validating emotional distress, providing counseling resources or support group referrals, involving mental health professionals when needed, educating about coping strategies, and acknowledging the significant impact hair loss can have on a patient's self-image, relationships, and quality of life.

A panelist discusses how they determine the appropriateness of a Janus kinase (JAK) inhibitor for patients by evaluating disease severity, duration, prior treatment failures, patient comorbidities, risk factors, and laboratory results and engaging in detailed benefit-risk discussions while setting realistic expectations about treatment outcomes and potential adverse effects.

A panelist discusses how determining whether a Janus kinase (JAK) inhibitor is the appropriate treatment for alopecia areata patients, which involves carefully evaluating disease severity, duration, and extent of hair loss, considering previous treatment failures, assessing patient comorbidities and risk factors, reviewing comprehensive laboratory results, discussing potential benefits vs risks of JAK therapy, and establishing realistic expectations about treatment timeline and potential adverse effects.

A panelist discusses how their traditional treatment approach for severe alopecia areata typically involved a stepped care pathway beginning with topical and intralesional steroids before progressing to systemic immunosuppressants or immunotherapy, which often yielded inconsistent, temporary, or incomplete hair regrowth results, leaving significant unmet needs for treatments that could provide sustained efficacy, acceptable safety profiles, and therapies specifically developed for this condition rather than repurposed from other dermatologic disorders.

A panelist discusses how dermatologists typically see patients with alopecia areata after they've already experienced significant hair loss and undergone initial treatments with primary care providers, which impacts treatment by creating potential delays in optimal intervention, heightened patient anxiety, and the need for more aggressive therapeutic approaches to address established disease patterns.

A panelist discusses how alopecia areata is clinically characterized by sudden, patchy hair loss with exclamation point hairs at the periphery and is typically diagnosed through clinical examination, dermoscopy, and sometimes scalp biopsy, noting that patients with a personal or family history of autoimmune disorders, certain genetic markers, or significant stress exposure may be at higher risk for developing this condition.

A panelist discusses how Dr. Mostaghimi approached them about enrolling in a trial for deuruxolitinib for alopecia areata after conventional treatments failed, initially prompting questions about the drug's mechanism, potential adverse effects, trial protocol requirements, and realistic expectations for hair regrowth outcomes.

A panelist discusses how they've tried various treatments for alopecia areata, including topical corticosteroids, intralesional steroid injections, immunotherapy, and Janus kinase inhibitors, with varying degrees of success in managing their condition, from temporary partial regrowth to more substantial and sustained hair restoration with newer targeted therapies.

A panelist discusses how Brea's patient journey involved a gradual recognition of unusual hair loss patterns, followed by an emotional diagnostic process for alopecia areata, which significantly impacted her quality of life through decreased self-confidence, social withdrawal, and psychological distress before finding effective treatment options.

A panelist discusses how finding an effective treatment for their condition has dramatically improved their mental health and quality of life by restoring their confidence and reducing anxiety about their appearance, allowing them to participate more fully in social activities and giving them a renewed sense of hope and normalcy.

A panelist discusses how ritlecitinib can be recommended for alopecia areata after previous treatments proved ineffective, initially raising questions about the medication's safety profile, potential adverse effects, and realistic timeline for hair regrowth.

A panelist discusses how they first noticed their hair loss through unexplained balding patches, which led to an eventual diagnosis of alopecia areata after consulting with a dermatologist who identified the autoimmune condition through physical examination and scalp analysis.

Mostaghimi highlights the major takeaways from his talk on alopecia areata therapies, the contents of which were presented at AAD 2025.

This summary, featuring 4 leading experts, provides an overview of what dermatologists may look forward to during the AAD 2025 Annual Meeting.

Panelists discuss the efficacy and safety data for ritlecitinib and deuruxolitinib in treating alopecia areata, highlighting that ritlecitinib achieved SALT scores of ≤20 in 23% of patients at week 24 compared to 1.6% in the placebo group, while deuruxolitinib showed SALT scores of ≤20 in 42.5% (8mg BID ) and 56.8% (12mg BID) of patients, with treatment-emergent adverse events primarily being mild to moderate, including upper respiratory tract infections and headaches for ritlecitinib, and headache and acne for deuruxolitinib.

Panelists discuss their clinical experiences with Janus kinase (JAK) inhibitors for treating alopecia, noting observed differences in outcomes and tolerability among various systemic JAK inhibitors, while highlighting the advantages of these therapies over traditional local and systemic treatment options.

Panelists discuss the long-term study results for baricitinib in alopecia areata, noting that nearly 90% of patients maintained a SALT score of ≤20 from week 52 to week 104, with over 70% achieving a SALT score of ≤10, while also addressing the reported treatment-emergent adverse events (TEAEs), which were mostly mild to moderate, with common events including COVID-19 infection and upper respiratory tract infections.

Panelists discuss the differences in mechanisms of action among the FDA-approved Janus kinase (JAK) inhibitors for alopecia, including baricitinib, deuruxolitinib, and ritlecitinib, and explore how selective inhibition differs from pan-inhibition in influencing treatment efficacy.

Panelists discuss the factors that guide their treatment decisions for alopecia areata, including severity, presentation, patient characteristics, and comorbid conditions, while also addressing how they prioritize these factors and incorporate patients’ expectations into their treatment strategy.

Panelists discuss how they assess the standard of care for managing alopecia areata.

Panelists discuss the pathophysiology of alopecia areata, including the risk factors for disease onset and progression, as well as the role of Janus kinase (JAK) in the disease’s mechanisms.

Panelists discuss the importance of early diagnosis of alopecia areata and how it influences treatment strategies and potential patient outcomes.

Panelists discuss how they determine disease severity in patients with alopecia areata, highlighting the tools used in clinical practice, such as the AA scale 2022 and the ASAMI study 2024.

Panelists discuss whether there are specific patient characteristics that are typically associated with the presentation of alopecia areata.

Panelists discuss how early diagnosis and the utilization of systemic Janus kinase inhibitors are crucial in the effective management of alopecia areata, highlighting the impact of disease severity and patient experiences on treatment strategies.