11 Oct Alopecia Areata: Switching JAK inhibitors May Achieve Hair Regrowth When Others Fail

Dr. King

Brett King, MD, PHD
 Dr. King was named an American Academy of Dermatology (AAD) “Patient Care Hero”
for his work treating patients with severe alopecia areata
Dermatology Physicians of Connecticut
Fairfield, Connecticut

MedicalResearch.com: What is the background for this study? Would you briefly explain the condition of Alopecia Areata?

Response: Alopecia Areata (AA), an autoimmune form of hair loss, is common and its treatment has been revolutionized in the past ~3 years with approvals of 3 JAK inhibitors, bariticinib, ritlecitinib and deuruxolitinib. Prior to these approvals, off label treatments included the JAK inhibitors tofacitinib and ruxolitinib.

In a world of multiple treatments, especially when those treatments belong to the same medicine class, the question arises “If patients do not achieve treatment success with one medicine, might they achieve treatment success with another one?”

Alopecia Areata courtesy of Dr. King

MedicalResearch.com: What are the main findings?

Response:  We show over a series of patients that successful treatment (complete or near-complete scalp hair regrowth) is achieved with a second, third, or even fourth JAK inhibitor after failure of one, two, or three other JAK inhibitors. 

MedicalResearch.com: What should readers take away from your report?

Response: The results are perhaps surprising and are very important for patients and providers, highlighting that patience, persistence, and familiarity with multiple JAK inhibitors is paramount for the optimal care of people living with AA. Treatment with any JAK inhibitor (e.g. baricitinib, ritlecitinib, deuruxolitinib, etc.) must be for a minimum of 6 months and sometimes even 9 months – looking for 30% or more scalp hair regrowth from baseline during that period or regrowth of eyebrows or eyelashes – before assessing whether or not to switch to a different one.

MedicalResearch.com: What recommendations do you have for future research as a results of this study?

Response: As the treatment landscape grows in AA, it will be interesting to see additional analyses like ours to better understand the biology and treatment responses of different patients to different agents.

Any disclosures: Dr. Brett King has served on advisory boards and/or is a consultant and/or is a clinical trial investigator and/or is on the speaker bureau for Abbvie, Bristol Meyers Squibb, Eli Lilly, Incyte, Pfizer, and Sun, who make JAK inhibitors for treatment of dermatologic conditions, including AA.

Citation:

Kalil L, Craiglow BG, King B. Successful Treatment of Alopecia Areata With One JAK Inhibitor After Failure of Other JAK Inhibitors. JAMA Dermatol. Published online October 08, 2025. doi:10.1001/jamadermatol.2025.3537

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Last Updated on October 11, 2025 by Marie Benz MD FAAD