Baricitinib and ritlecitinib in alopecia areata: A nationwide prospective real-world registry study
In brief
Baricitinib and ritlecitinib show similar hair regrowth in alopecia areata
In a prospective registry of 166 adults with severe alopecia areata, scalp hair loss scores improved over 12 months with both drugs, with no significant difference between treatments. Among patients assessed at 12 months, 64% taking baricitinib and 50% taking ritlecitinib reached a score indicating limited hair loss; the nonrandomized design leaves comparative effectiveness uncertain.
- Journal
- JAAD international (Q1)
- Published
- 1 October 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Mathias Willaert, Sophie C van Helmond, Lieke van Vugt, Antoni Gostyński, Tristan H van Dongen, Sherief R Janmohamed, et al.
- PMID
- 42991038
- DOI
- 10.1016/j.jdin.2026.09.010
Why clinicians should know about it
- Picked for Dermatology (paper of the day, 7 November 2026): Real-world effectiveness of JAK inhibitors for alopecia areata
Abstract
BACKGROUND: Janus kinase inhibitors baricitinib and ritlecitinib are approved for the treatment of severe alopecia areata (AA). However, prospective real-world data on effectiveness, disease burden, and tolerability are limited. OBJECTIVE: To evaluate the real-world effectiveness and tolerability of baricitinib and ritlecitinib in adults with AA. METHODS: In this nationwide, prospective, multicenter registry (Systemic Treatments for Alopecia Areata Registry), adults initiating baricitinib or ritlecitinib between January 2024 and April 2026 were included. The primary outcome was Severity of Alopecia Tool (SALT) score trajectory over 12 months, analyzed using a linear mixed model adjusted for baseline SALT score, AA subtype, age, sex, atopic history, disease duration, prior treatment response, and prior Janus kinase inhibitor use. RESULTS: A total of 166 patients were included (baricitinib, n = 106; ritlecitinib, n = 60). SALT scores declined significantly over time in both groups (β = -4.22 points/mo), with no significant difference between treatments. At 12 months, adjusted SALT scores were 33.7 for baricitinib and 33.4 for ritlecitinib, with SALT ≤20 achieved by 30 of 47(64%) and 12 of 24(50%) of patients, respectively. Both treatments were associated with improvements in disease burden and were well tolerated. LIMITATIONS: Nonrandomized design with potential confounding by indication; decreasing sample sizes at later time points reflecting ongoing registry accrual. CONCLUSIONS: Baricitinib and ritlecitinib demonstrated similar scalp hair regrowth in this prospective real-world cohort.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.