Therapeutic Burden as Predictor of Response to Baricitinib for Alopecia Areata in Real Life: Prospective Study
Abstract Introduction Therapeutic burden (TB) has been proposed as a potential predictor of treatment outcomes in both dermatological and non-dermatological diseases. This study aims to introduce the concept in the context of alopecia areata (AA) and assess its potential value in supporting therapeu...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Adis, Springer Healthcare
2025-07-01
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| Series: | Dermatology and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s13555-025-01468-1 |
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| Summary: | Abstract Introduction Therapeutic burden (TB) has been proposed as a potential predictor of treatment outcomes in both dermatological and non-dermatological diseases. This study aims to introduce the concept in the context of alopecia areata (AA) and assess its potential value in supporting therapeutic decision-making in clinical practice. Methods A prospective cohort study was conducted including patients with AA who started treatment with baricitinib between January 2022 and January 2025 at a third-level hospital center. The main variable was TB, defined as the cumulative sum of previous systemic treatment cycles. An analysis was performed on whether socio-demographic or clinical factors were associated with TB. Results Forty-four patients with AA treated with baricitinib were included. Most were women (65.90%) with a mean age of 37.70 (16.10) years. The predominant type of AA was multi-plaque (65.90%) and approximately one third (34.10%) had total/universal forms of the disease. Lower TB was statistically significantly associated with a greater reduction in Severity of Alopecia Tool (SALT) scores during the first 12 months of barictinib treatment compared with those patients with high TB (p < 0.05). This association was observed independently of all other known progression factors (duration of AA, baseline SALT, total/universal AA, female sex) (p < 0.05). Conclusions We present the concept of AA-adapted TB as a useful tool for categorizing patients with AA and contributing to therapeutic decision-making. Patients with AA with low TB showed a greater response to baricitinib treatment than patients who had received a greater number of systemic treatments previously. |
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| ISSN: | 2193-8210 2190-9172 |