Reversal of Alopecia Areata Following Treatment With the JAK1/2 Inhibitor Baricitinib

EBioMedicine. 2015 Feb 26;2(4):351-5. doi: 10.1016/j.ebiom.2015.02.015. eCollection 2015 Apr.

Abstract

Background: Alopecia areata (AA) is an autoimmune disease resulting in hair loss with devastating psychosocial consequences. Despite its high prevalence, there are no FDA-approved treatments for AA. Prior studies have identified a prominent interferon signature in AA, which signals through JAK molecules.

Methods: A patient with AA was enrolled in a clinical trial to examine the efficacy of baricitinib, a JAK1/2 inhibitor, to treat concomitant CANDLE syndrome. In vivo, preclinical studies were conducted using the C3H/HeJ AA mouse model to assess the mechanism of clinical improvement by baricitinib.

Findings: The patient exhibited a striking improvement of his AA on baricitinib over several months. In vivo studies using the C3H/HeJ mouse model demonstrated a strong correlation between resolution of the interferon signature and clinical improvement during baricitinib treatment.

Interpretation: Baricitinib may be an effective treatment for AA and warrants further investigation in clinical trials.

Keywords: Alopecia areata; Autoimmune disease; Autoinflammatory; Baricitinib; CANDLE syndrome; Gene expression profiling; Interferon gamma; JAK inhibitor.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alopecia Areata / drug therapy*
  • Alopecia Areata / enzymology*
  • Animals
  • Azetidines / therapeutic use*
  • Disease Models, Animal
  • Interferons / metabolism
  • Janus Kinases / antagonists & inhibitors*
  • Male
  • Mice, Inbred C3H
  • Protein Kinase Inhibitors / therapeutic use*
  • Sulfonamides / therapeutic use*

Substances

  • Azetidines
  • Protein Kinase Inhibitors
  • Sulfonamides
  • Interferons
  • Janus Kinases
  • baricitinib