WEDNESDAY, April 9, 2025 -- In patients with alopecia areata (AA), the severity of eyebrow (EB) and eyelash (EL) involvement parallels that of scalp hair loss severity, and baricitinib is efficacious for achieving response across all sites, according to a study published online April 3 in the British Journal of Dermatology.

Arash Mostaghimi, M.D., M.P.H., from Brigham and Women's Hospital in Boston, and colleagues reported integrated results from BRAVE-AA1 and BRAVE-AA2, conducted at 169 centers in 10 countries. Patients were randomly assigned to placebo, baricitinib 2 mg, or baricitinib 4 mg; data were included from patients treated through week 52.

The researchers found that patients with more severe EB/EL involvement at baseline had more severe scalp hair loss, with mean Severity of Alopecia Tool scores ranging from 70.6 to 96.0 for patients with no gaps to complete absence of hair, respectively, at EB/EL sites. Patients treated with baricitinib 2 mg and baricitinib 4 mg had significantly higher EB/EL response rates at week 36 (odds ratios, 3.27 and 2.95, respectively, for baricitinib 2 mg; 6.84 and 8.21, respectively, for baricitinib 4 mg). EB and EL responses were highly concordant; about 80 percent of patients who achieved hair regrowth at one site also achieved regrowth at the other site with baricitinib 4 mg. Among scalp responders, 78.5 and 82.6 percent achieved an EB and EL response, respectively; a response in both was achieved by 71.1 percent with baricitinib 4 mg. Similar trends were seen with baricitinib 2 mg, but response rates were lower.

"In the optimal management of patients, these data can inform on the benefits of baricitinib across important sites of involvement in severe AA," the authors write.

Several authors disclosed ties to biopharmaceutical companies, including Eli Lilly, which manufactures baricitinib and funded the study.