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Does Baricitnib Help Treat Alopecia Areata?

Katelyn Hagerty

Reviewed by Katelyn Hagerty, FNP

Written by Geoffrey Whittaker

Published 03/25/2023

If you’ve been experiencing hair loss due to an immune condition, you may have the opportunity to try baricitinib alopecia areata treatment as a solution for scalp hair regrowth.

Discovering a new disorder is always a jarring experience. When the condition affects your health and the way you look, it can ravage your confidence, lower your self-esteem and generally cause stress and anxiety levels to skyrocket. It can make you unsure, slow to make decisions, and above all, worried about risks. 

Baricitinib is a perfect example of a hard-to-pronounce medication you’ve likely never heard of. But while your first instinct may be wariness, we have good news.

First, there are multiple pronunciations of this medication, so you don’t have to worry about feeling silly. Not only that, but this medication might actually be a potential solution to your hair woes.

That said, there are also some serious safety concerns you should know about before taking your first dose of baricitinib — we’ll get to those in a minute.

Let’s start with how baricitinib works.

It’s important to get the complicated stuff out of the way first because the sooner we get over that hurdle, the sooner you’ll feel confident to make decisions about your health.

Baricitinib is a janus kinase inhibitor (also called a once-daily, oral JAK inhibitor). This might mean nothing to you on its own, but bear with us for a second.

Janus kinases are enzymes that regulate certain immune cell functions in the body. When they’re not working properly, they can cause disorders of the immune system — aka autoimmune diseases. A couple of these include rheumatoid arthritis and alopecia areata.

By inhibiting this enzyme, baricitinib can prevent an out-of-control immune system from attacking your own body, the way it does in autoimmune conditions.

Studies have demonstrated that it’s effective in rheumatoid arthritis treatment. Specifically, clinical trials have shown it halt the progression of rheumatoid arthritis and limit how the disease functions.

Rheumatoid arthritis, of course, is not alopecia areata, so you’re probably wondering if this medication can work for other autoimmune disorders.

Studies are still trying to answer that question completely. 

The FDA (U.S. Food and Drug Administration) approved the brand name Olumiant of baricitinib in 2022. To date, clinical trials for baricitinib Olumiant treatment have shown promise for its potential in fighting alopecia areata.

A 2022 assessment of two clinical trials showed that over a period of 36 weeks, baricitinib treatment in patients with alopecia areata was more effective than a placebo in helping them regrow hair.

That’s an impressive outcome, and considering the combined trials for this study exceeded 1,000 participants, the numbers are significant.

The researchers reviewing these clinical studies concluded that while the results were promising, further studies with longer timeframes are needed to understand the potential and limitations of this medication.

Most importantly, however, we need to contextualize these positive results within the bigger picture of baricitinib and its safety profile. After all, this medication poses some serious and potentially fatal risks of adverse effects, which should be considered along with the benefits of treatment.

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Here’s the big caveat for using baricitinib: since it’s an immunosuppressant drug, it does make you more likely to experience illness, infections and other health issues due to a more vulnerable immune system.

As such, people with tuberculosis, HIV, fungal infections and other ongoing medical issues shouldn’t be taking this medication until those issues have been resolved.

People who take once-daily baricitinib may also experience side effects and adverse events, including:

  • Nausea

  • Vomiting

  • Abdominal pain

  • Pulmonary embolism

  • Deep vein thrombosis or blood clots

  • Anemia

  • Bone marrow suppression

  • Increased upper respiratory infections

  • Increased urinary tract infections

According to the FDA, using baricitinib increases your risk of serious infections, be they bacterial, viral or fungal. For instance, it might make you more susceptible to contracting coronavirus disease.

Those infections might lead to hospitalization and potentially death, which is why it’s important to talk to a professional about this medication and bring any and all side effects to their attention.

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Baricitinib is considered safe to use when taken as directed. Still, you have to take into account the risks and side effects that this medication could bring into your life.

Over time, baricitinib may also increase your risk of lymphomas and lung cancer. And the FDA notes that higher incidences of cardiovascular events as a potential cause of death (such as heart attack) occur in people using this medication.

So safety is relative. For people with debilitating rheumatoid arthritis, those risks may be acceptable to maintain a higher quality of life. For alopecia areata, we really can’t make that decision for you.

Current medical recommendations primarily focus on corticosteroids for the treatment of severe alopecia areata, though there is also some benefit to medications like minoxidil that promote hair growth by dilation of the vascular tissues around the hair follicles themselves.

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Baricitinib may be an option for the management of alopecia areata in your particular circumstances. But since the drug has some potentially serious side effects to consider, you should talk at length with a healthcare provider about the risks before starting treatment.

The next step is having that conversation. Whether you’ve been diagnosed or not, talking with a healthcare provider can help you get the guidance you need — for this medication or another. 

If you’re not sure where to start, we can help. Our hair health resources can answer your questions about alopecia areata treatment options, the symptoms of alopecia areata and more. 

We can also help you find the right treatment for your needs. Get started today.

4 Sources

  1. Lepe K, Zito PM. Alopecia Areata. [Updated 2022 Aug 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537000/.
  2. Highlights of prescribing information limitations of use: Not ... (n.d.). Retrieved January 31, 2023, from https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/207924s006lbl.pdf.
  3. Ahmad A, Zaheer M, Balis FJ. Baricitinib. [Updated 2022 Jul 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572064/.
  4. King, B., Ohyama, M., Kwon, O., Zlotogorski, A., Ko, J., Mesinkovska, N. A., Hordinsky, M., Dutronc, Y., Wu, W. S., McCollam, J., Chiasserini, C., Yu, G., Stanley, S., Holzwarth, K., DeLozier, A. M., Sinclair, R., & BRAVE-AA Investigators (2022). Two Phase 3 Trials of Baricitinib for Alopecia Areata. The New England journal of medicine, 386(18), 1687–1699. https://www.nejm.org/doi/10.1056/NEJMoa2110343.
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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.