Baricitinib and ritlecitinib in alopecia areata: A nationwide prospective real-world registry study
6 affiliations
- 1Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
- 2Department of Dermatology, Maastricht University Medical Center, Maastricht, The Netherlands
- 3Department of Dermatology, Spaarne Gasthuis, Haarlem, The Netherlands
- 4Department of Dermatology, Intermedica Kliniek, Wijchen, The Netherlands
- 5Department of Dermatology, Bernhoven Hospital, Uden, The Netherlands
- 6Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
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.
Related
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- Baricitinib Efficacy Through 4 Years in Responders and Safety up to 5 Years in Adults with Severe Alopecia Areata: Final Results from BRAVE-AA1 and BRAVE-AA2
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BibTeX
@article{willaert2026baricitinib,
title = {{Baricitinib and ritlecitinib in alopecia areata: A nationwide prospective real-world registry study}},
author = {Mathias Willaert and Sophie C. van Helmond and Lieke van Vugt and Antoni Gostyński and Tristan H. van Dongen and Sherief R. Janmohamed and Manon Zweers and Tamar E.C. Nijsten and DirkJan Hijnen and Rick Waalboer-Spuij},
journal = {JAAD International},
year = {2026},
month = oct,
doi = {10.1016/j.jdin.2026.09.010},
url = {https://doi.org/10.1016/j.jdin.2026.09.010},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Baricitinib and ritlecitinib in alopecia areata: A nationwide prospective real-world registry study
AU - Mathias Willaert
AU - Sophie C. van Helmond
AU - Lieke van Vugt
AU - Antoni Gostyński
AU - Tristan H. van Dongen
AU - Sherief R. Janmohamed
AU - Manon Zweers
AU - Tamar E.C. Nijsten
AU - DirkJan Hijnen
AU - Rick Waalboer-Spuij
PY - 2026
DA - 2026/10/01
JO - JAAD International
DO - 10.1016/j.jdin.2026.09.010
UR - https://doi.org/10.1016/j.jdin.2026.09.010
AB - 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.
SN - 2666-3287
ER -