Welcome to Dermbits! Watch short videos of KOLs answering your questions

thumbnail_dermbits-colorful.png

dermbits-colorful.png

Dermbits

Lilly Olumiant AA October 2023

Can baricitinib be used in combination with topical treatments?

Alopecia

You. So when we talk about treating patients that come into our office that have alopecia, that's not just a few patches, but they have fairly extensive involvement. They may have 50, 60, 70% scalp hair loss. It may be actually increasing each time that they're coming in, and they might have eyebrow and eyelash involvement. Also, in the clinical trials with oral baricitinib, these were patients with severe disease that had at least 50% involvement with hair loss on their scalp. Now, in the real world, we may be looking at utilizing oral baricitinib at either a two milligram or a four milligram dose once a day, but will often supplement with other treatments. We might treat certain areas with intralesional triasin alone injection to augment some areas and get quicker benefit. In some cases, topical therapies and quite frankly, a lot of the topical therapies have been hit or miss, but with topical minoxidil, which is commonly used for pattern alopecia in males and females, androgenetic alopecia, but it's been used for alopecia areata. My caveat of concern is this is a very slow onset medication, and if it's kicking in in terms of preserving hair, that it's not being shed. If it's stopped, patients will often shed what they've been holding on to, and I don't want that to happen. In the case of alopecia areata, we've known that from androgenetic alopecia, but I'm cautious. If a patient wants to use topical minoxidil, they have to start it and they have to stick with it, because if they touch and go or abruptly discontinue, they may lose some of that effect. We don't know if that would be the case while they're on a Janus kinase inhibitor like baracetinib, but I'd still be concerned about that. So I really don't like to see patients using topical minoxidil because it's hard to be compliant when you're utilizing it for a condition like lapisha areata.

Can baricitinib be used in combination with topical treatments?

Related CME