Baricitinib Withdrawal and Retreatment in Patients With Severe Alopecia Areata

Key Points Question What are the short-term and long-term relapse rates following treatment withdrawal in patients with severe alopecia areata who achieved a response after 52 weeks of baricitinib, 2 mg, or baricitinib, 4 mg, once daily? Findings In this randomized clinical trial of 654 adults with severe alopecia areata, at 4 and 8 weeks, 0% and 10% to 11% of patients, respectively, experienced a loss of treatment benefit, which increased to 80% or more by week 152. With retreatment, most patients recaptured response during the follow-up observation period (2 mg, 63%; 4 mg, 85%). Meaning The results of this trial suggest that severe alopecia areata is a relapsing condition requiring maintenance therapy after successful regrowth has been achieved.