Baricitinib Has Reinvigorated Patients with Alopecia Areata


Brett King, MD, PhD, discusses the newly available JAK inhibitor—the first systemic therapy approved for the hair-loss condition.

The US Food and Drug Administration (FDA) approved oral baricitinib (Olumiant) for the treatment of severe alopecia aerata in adult patients in June, making the JAK inhibitor the first systemic therapy indicated for the common hair-loss disorder.

Since that historic decision on June 13, the scope of dermatologists’ work has changed in the US. Brett King, MD, PhD, told HCPLive how we used to average approximately 10 new clinic hair-loss consults per week. In the month following baricitinib’s approval, he had received about 150 consults.

“We really have been waiting for this moment forever,” King said. “Since the very first patient was treated with off-label tofacitinib 8 years ago, I think many of us had the sense that we’re on a different road now.”

In an interview with HCPLive during the 2022 Fall Clinical Dermatology Meeting this week, King discussed the seismic shifts in alopecia treatment and diagnostics over the last 5 months with an approved agent to treat it. He always knew to anticipate an uptick in consults when the opportunity to resolve alopecia would arrive; the good news comes with unique challenges, though.

“That means we’re going to see in general more patients with hair loss,” King explained. “So I think we need to be mindful that not every round patch of hair loss is alopecia areata.”

On the topic of patient populations most interested in baricitinib, King said “it’s truly the spectrum.”

“On the one hand, it’s people who have seen 8, 10, 15 doctors over 10 years, and they stopped going,” he said. “But it’s also the folks who have been seeing doctors, seeing their disease get worse, but they’re at 30% hair loss.”

While the introduction of a systemic therapy means a necessary reprioritization of screening and prescribing, it’s a dream come true that dermatologists are now equipped with “a medicine that’s going to restore normalcy.”

“We’ve finally landed at the goal, and the future is bright now," he said.

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