The Triumph of JAK Inhibitors for the Treatment of Alopecia Areata

Alopecia areata (AA), with a disease incidence of 2% in the USA, is the most common immune-mediated cause of hair loss in the world. There were no FDA approved treatments for AA in the past. All treatment modalities used alone or in combination with each other, were prescribed off label. The JAK inhibitor baricitinib was approved by the FDA in June 2022. While it’s a significant leap forward, we are still missing the safety profile data in multiple areas. Topical JAK inhibitors are being tested along with sublingual options including tofacitinib, ruxolitinib, and ritlecitinib. In this review, we discuss the JAK inhibitor baricitinib in detail, along with its dosing regimen, challenges presented in the clinic, missing data, and what the future may hold.