Baricitinib: First Systemic Oral Drug for Alopecia Therapy

Prashant Mishra; Sharmila Sinha; Sandeep Vihan; Navdeep Dahiya; Biju Vasudevan

doi:10.18502/jpc.v10i3.10797

Prashant Mishra Deptartment of Pharmacology, Armed Forces Medical College, Pune-40, India.
Sharmila Sinha Deptartment of Pharmacology, Armed Forces Medical College, Pune-40, India.
Sandeep Vihan Deptartment of Pharmacology, Armed Forces Medical College, Pune-40, India.
Navdeep Dahiya Deptartment of Pharmacology, Armed Forces Medical College, Pune-40, India.
Biju Vasudevan Department of Dermatology, Armed Forces Medical College, Pune-40, India.

DOI: https://doi.org/10.18502/jpc.v10i3.10797

Keywords: Alopecia; Baricitinib; Hair Follicle; Janus Kinase Inhibitors

Abstract

Baricitinib, a Janus kinase inhibitor, was originally approved as anti-rheumatic drug in 2017. In 2020, it was approved for the treatment of COVID-19 in selected hospitalized adults. Baricitinib received priority review designation for treatment of adult patients with severe alopecia areata and got USFDA approval on June 23, 2022 based on the results of 02 phase III trial: BRAVE-AA1 and BRAVE-AA2. In this review, we aim to summarize the different pharmacokinetic and pharmacodynamics aspects including drug interactions, adverse effects/black box warnings and their clinical relevance. We reiterate that oral JAK inhibitors are expensive, may carry significant risks, and are not yet recommended for routine treatment of alopecia areata. There is ongoing research on other topical and oral JAK inhibitors (tofacitinib and ruxolitinib), giving hope that better treatments for alopecia areata will become available in future.