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Introduction <p>Scalp hair regrowth in severe alopecia areata (AA) can occur rapidly or take up to 2&#xa0;years in some patients. Baseline factors influence the likelihood and/or timing of treatment response with Janus kinase inhibitors. We evaluated initial evidence of improvement (Severity of Alopecia Tool<sub>30</sub>) and subsequent treatment success (SALT score ≤ 20) in four subgroups defined by baseline disease severity and AA episode duration to inform the treatment length required before assessing failure, based on disease presentation.</p> Methods <p>In a post hoc analysis of BRAVE-AA1/2 (NCT03570749/NCT03899259), baricitinib 4&#xa0;mg treatment subgroups were assessed for SALT<sub>30</sub> and subsequent SALT score ≤ 20 over time.</p> Results <p>In severe AA (SALT score 50–94), SALT<sub>30</sub> occurred in 70% of those with short duration and 61% with long duration by Week 24, leading to 75% and 65% achieving treatment success (SALT score ≤ 20) by Week 52. In very severe AA (SALT score 95–100), regrowth varied by short/long episode duration with SALT<sub>30</sub> achieved in 42%/25% of patients by Week 24, leading to SALT score ≤ 20 in 58%/43% at Week 52, respectively.</p> Conclusions <p>Severe subgroups usually achieve SALT<sub>30</sub> by Week 24. In very severe AA, proportions achieving SALT<sub>30</sub> increased through Week 52; therefore, treatment should be given for ≥ 1&#xa0;year before assessing treatment failure.</p>

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How Long to Treat to Achieve Desired Treatment Outcomes with Baricitinib 4 mg in Severe Alopecia Areata: Evidence-based Approach

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月16日

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  • Brett King,
  • Maryanne Senna,
  • Manabu Ohyama,
  • Rodney Sinclair,
  • Najwa Somani,
  • Na Lu,
  • Yun-Fei Chen,
  • Jakub Jedynak,
  • Andrew Buchanan,
  • Bianca Maria Piraccini

摘要

Introduction

Scalp hair regrowth in severe alopecia areata (AA) can occur rapidly or take up to 2 years in some patients. Baseline factors influence the likelihood and/or timing of treatment response with Janus kinase inhibitors. We evaluated initial evidence of improvement (Severity of Alopecia Tool30) and subsequent treatment success (SALT score ≤ 20) in four subgroups defined by baseline disease severity and AA episode duration to inform the treatment length required before assessing failure, based on disease presentation.

Methods

In a post hoc analysis of BRAVE-AA1/2 (NCT03570749/NCT03899259), baricitinib 4 mg treatment subgroups were assessed for SALT30 and subsequent SALT score ≤ 20 over time.

Results

In severe AA (SALT score 50–94), SALT30 occurred in 70% of those with short duration and 61% with long duration by Week 24, leading to 75% and 65% achieving treatment success (SALT score ≤ 20) by Week 52. In very severe AA (SALT score 95–100), regrowth varied by short/long episode duration with SALT30 achieved in 42%/25% of patients by Week 24, leading to SALT score ≤ 20 in 58%/43% at Week 52, respectively.

Conclusions

Severe subgroups usually achieve SALT30 by Week 24. In very severe AA, proportions achieving SALT30 increased through Week 52; therefore, treatment should be given for ≥ 1 year before assessing treatment failure.