{
  "abstract": "Background/Objectives: Janus kinase inhibitors (JAKis) have transformed the treatment of alopecia areata (AA), but pivotal trials had short follow-ups and real-world long-term safety data remain scarce. We compared incident adverse outcomes between patients with AA exposed and not exposed to JAKis. Methods: In this retrospective cohort study of the TriNetX Global Collaborative Network, adults (≥18 years) with ≥2 diagnoses of AA (ICD-10-CM L63) and ≥2 medication events for baricitinib, tofacitinib, ritlecitinib, or oral ruxolitinib were matched 1:1 by propensity score on demographics and 13 comorbidities to patients with AA and no recorded exposure to these agents. Cox models estimated hazard ratios (HRs); p values for the 19 estimable outcomes were adjusted using the Benjamini–Hochberg procedure (false discovery rate 5%), and E-values assessed unmeasured confounding. Drug-specific and eight sensitivity analyses were performed. Results: Matching yielded 1771–1805 patients per cohort, depending on the outcome domain. Acne was more frequent with JAKis (HR, 2.425; 95% CI, 1.838–3.200; q < 0.001) in all analyses, including versus conventional immunosuppressants (HR, 1.688; 95% CI, 1.321–2.157), whereas upper respiratory tract infections (HR, 0.620; 95% CI, 0.476–0.808; q = 0.004) and urinary tract infections (HR, 0.458; 95% CI, 0.290–0.724; q = 0.006) were recorded less frequently. Cutaneous cancer was more frequent (HR, 2.639; 95% CI, 1.322–5.270; q = 0.024) and persisted after 30- and 180-day latency periods but was attenuated under a fixed 2-year follow-up and after exclusion of other JAKi indications. Severe infections, herpes zoster, and autoimmune and psychiatric outcomes did not differ significantly. Conclusions: In real-world AA care, JAKis were not associated with a statistically significant increase in severe infections or incident psychiatric outcomes, although power for rare serious outcomes was limited. Acne was the most consistent adverse-event signal, whereas the cutaneous cancer finding was not fully robust across specifications and requires confirmation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Dermatology, Research and Development Centre, Regional Specialist Hospital, Kamieńskiego 73a, 51-124 Wroclaw, Poland",
    "Division of Dermatology, Venereology and Clinical Immunology, Faculty of Medicine, Wroclaw University of Science and Technology, Wybrzeże Stanisława Wyspiańskiego 27, 50-370 Wroclaw, Poland",
    "Department of Dermatovenereology, 4th Military Hospital, Rudolfa Weigla 5, 50-981 Wroclaw, Poland"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Mateusz Łysek",
      "orcid": "0009-0000-3370-300X"
    },
    {
      "affs": [
        1
      ],
      "name": "Beata Jastrząb-Miśkiewicz"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Piotr K. Krajewski",
      "orcid": "0000-0003-4722-8531"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/02pmc6zyef5bv.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15207825",
  "fulltext_url": "https://europepmc.org/articles/PMC13705346",
  "id": "02pmc6zyef5bv",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/20/7825",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2748|Hair Growth and Disorders"
    ]
  ],
  "openalex": "W7221507821",
  "pdf_url": "https://europepmc.org/articles/PMC13705346?pdf=render",
  "pmcid": "PMC13705346",
  "pmid": "42941340",
  "published": "2026-10-10",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/02pmc6zyef5bv.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:00Z",
      "native_id": "10.3390/jcm15207825",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/7825"
    },
    {
      "first_seen": "2026-10-30T12:22:24Z",
      "native_id": "MED:42941340",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42941340"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2748|Hair Growth and Disorders",
      "subfield": "general"
    }
  ],
  "title": "Real-World Safety of Janus Kinase Inhibitors in Alopecia Areata: A Propensity Score-Matched Cohort Study of a Global Federated Health Network",
  "title_text": "Real-World Safety of Janus Kinase Inhibitors in Alopecia Areata: A Propensity Score-Matched Cohort Study of a Global Federated Health Network",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:24Z",
  "url": "https://research.draconitic.com/paper/02pmc6zyef5bv",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}