Reversal of Alopecia Areata Following Treatment With the JAK1/2 Inhibitor Baricitinib

  • EBioMedicine. 2015 Feb 26;2(4):351-5. doi: 10.1016/j.ebiom.2015.02.015.
Ali Jabbari  1 ,  Zhenpeng Dai  1 ,  Luzhou Xing  2 ,  Jane E Cerise  1 ,  Yuval Ramot  3 ,  Yackov Berkun  4 ,  Gina A Montealegre Sanchez  5 ,  Raphaela Goldbach-Mansky  5 ,  Angela M Christiano  6 ,  Raphael Clynes  7 ,  Abraham Zlotogorski  3
Affiliations
  • 1. Department of Dermatology, Columbia University, New York, NY, USA.
  • 2. Department of Pathology, Columbia University, New York, NY, USA.
  • 3. Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
  • 4. Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
  • 5. Translational Autoinflammatory Disease Section, NIAMS, NIH, Bethesda, MD, USA.
  • 6. Department of Dermatology, Columbia University, New York, NY, USA ; Department of Genetics & Development, Columbia University, New York, NY, USA.
  • 7. Department of Dermatology, Columbia University, New York, NY, USA ; Department of Pathology, Columbia University, New York, NY, USA ; Department of Medicine, Columbia University, New York, NY, USA.
PMID: 26137574 DOI: 10.1016/j.ebiom.2015.02.015
Abstract

Background: Alopecia areata (AA) is an autoimmune disease resulting in hair loss with devastating psychosocial consequences. Despite its high prevalence, there are no FDA-approved treatments for AA. Prior studies have identified a prominent interferon signature in AA, which signals through JAK molecules.

Methods: A patient with AA was enrolled in a clinical trial to examine the efficacy of baricitinib, a JAK1/2 inhibitor, to treat concomitant CANDLE syndrome. In vivo, preclinical studies were conducted using the C3H/HeJ AA mouse model to assess the mechanism of clinical improvement by baricitinib.

Findings: The patient exhibited a striking improvement of his AA on baricitinib over several months. In vivo studies using the C3H/HeJ mouse model demonstrated a strong correlation between resolution of the interferon signature and clinical improvement during baricitinib treatment.

Interpretation: Baricitinib may be an effective treatment for AA and warrants further investigation in clinical trials.

Keywords
Alopecia areata; Autoimmune disease; Autoinflammatory; Baricitinib; CANDLE syndrome; Gene expression profiling; Interferon gamma; JAK inhibitor.
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