Switching Between JAK Inhibitors Viable for Severe Alopecia Areata
Patients who responded to their first Janus kinase inhibitor were more likely to respond to a second one
By Dermsquared Editorial Team | March 05, 2026
WEDNESDAY, Feb. 18, 2026 (HealthDay News) -- For patients with severe alopecia areata (AA), switching between Janus kinase inhibitors (JAKis) is viable, especially for those who responded to a prior JAKi, according to a study published online Jan. 30 in the Journal of the American Academy of Dermatology.
Aubrey Martin, from Lahey Hospital & Medical Center in Burlington, Massachusetts, and colleagues examined the efficacy and safety of switching between JAKis in patients with severe AA in a multicenter study. A total of 108 patients with severe AA who switched between oral JAKis after a minimum treatment duration of six months were analyzed.
The researchers found that 48.8 and 32.6 percent of patients achieved Severity of Alopecia Tool (SALT) ≤20 and ≤10, respectively, on their second JAKi. Of the 24 patients who received a third JAKi, 52.4 and 38.1 percent achieved SALT ≤20 and ≤10, respectively. The likelihood of responding to a second JAKi was increased for patients who responded to their first JAKi (odds ratio, 3.33). Mild adverse events were seen, which were consistent with prior reports.
"Our findings suggest that JAKi switching can be a useful strategy in the management of severe AA, particularly among patients who demonstrate some degree of response to initial therapy," the authors write.