Brett King, MD, PhD: Baricitinib Impact on Regrowth of Scalp, Eyebrow, Eyelash Hair with Alopecia Areata

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These phase 3 findings from AAD 2024 suggest patients treated with baricitinib may continue to see scalp, eyelash, and eyebrow hair regrowth with specific dosing regimens.

Between weeks 52 and 104, individuals with alopecia areata continued to report hair regrowth in their scalp, eyebrows, and eyelashes using both 2 mg and 4 mg doses of baricitinib for up to 152 weeks, according to findings presented at the 2024 American Academy of Dermatology (AAD) Annual Meeting.

The study participants had completed assessments on their regrowth during the BRAVE-AA1 and BRAVE-AA2 studies. Patients with a Severity of Alopecia Tool (SALT) score of ≥50 were randomly assigned to either be given continuous baricitinib with a dose of 2 mg or 4 mg.

In this interview with HCPLive, Brett King, MD, PhD, associate professor of dermatology at the Yale School of Medicine, spoke on these phase 3 findings and the medication’s long-term efficacy in promoting hair regrowth.

“Roughly 35% of patients at the 4 mg dose achieve complete or near complete scalp hair regrowth,” King said. “We know that over an additional 16 weeks of treatment…35% moves to roughly 39% or 40% of patients achieving scalp hair regrowth. We know that it's not that you get scalp hair regrowth or not, but rather, there are a whole bunch of patients who are sitting at the door of complete or near complete scalp hair regrowth. They've regrown, they just didn't get to the primary endpoint.”

During these studies, improvement in each patient reported outcome (PRO) was considered to be meaningful if it led to a score of 0 or 1 with a ≥2-point increase from the point of baseline, noted at weeks 52, 104, and 152.

“What we see in this analysis is that watching that group of patients, watching people who have eyebrows and/or eyelashes regrowth at Week 52, many of them who did not already have scalp hair regrowth regrow scalp hair," King said. "Indeed, over a long period of observation, up to 39% of those people regrow their scalp pair or continue to grow scalp hair and achieve a very low SALT score. So really, it tells us that when we have a patient sitting in front of us at month 9, they started with severe alopecia…This data says there's a really good chance that if we keep them on treatment, that they're going to regrow scalp hair.”

King added that the successful regrowth of eyebrows and eyelashes may suggest that dermatologists should stick with this treatment for another 6 months. Afterward, he was asked about the safety profile.

“We really see that the safety profile at early time points really does not change over longer periods of observation in any way that should raise red flags for us,” King said. “To be able to tell our patients, ‘by the way, in this many patients treated for up to 3 years, we don't see new or changing safety signals that give us concern.’ And so this truly informs the way we take care of our patients.”

For further information from King’s team’s research, view the full interview segment above.

The quotes contained here were edited for the purposes of clarity.

References

  1. Patient-Reported Outcomes for Scalp, Eyebrow and Eyelash Hair Loss in Patients with Severe Alopecia Areata Treated with Baricitinib: 152 Week Results from two Phase 3 Clinical Trials. Oral presentation (Abstract #52709) at the American Academy of Dermatology (AAD) 2024 Annual Meeting. March 2024.
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