Piraccini B M, Pampaloni F, Cedirian S, Quadrelli F, Bruni F, Rapparini L, Caro G, Acri M C, Ala L, Rossi A, Pellacani G, Lacarrubba F, Micali G, Dall'Oglio F, Vastarella M, Cantelli M, Nappa P, Diluvio L, Bianchi L, Gnesotto L, Sechi A, Naldi L, Tassone F, Peris K, Caldarola G, Pinto L M, Girolomoni G, Marangoni F, Bellinato F, Gisondi P, Scandagli I, Prignano F, Pimpinelli N, Tomasini C, Barruscotti S, De Simoni E, Simonetti O, Ambrogio F, Foti C, Boccaletti V, Fraghì A, Marzano A V, Mattioli M A, Rocca L, Barbareschi M, Ferrucci S M, Gallo G, Ribero S, Quaglino P, Balestri R, Ioris T, Caposiena Caro R D, Zalaudek I, Vagnozzi E, Fargnoli M C, Caponio C, Rubegni P, Cinotti E, Trovato E, Romanelli M, Dini V, Manzo Margiotta F, Feliciani C, de Felici Del Giudice M B, Atzori L, Sanna S, Lembo S, Raimondo A, Magnano M, Starace M
Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy.
Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
J Eur Acad Dermatol Venereol. 2025 Jun;39(6):1143-1151. doi: 10.1111/jdv.20312. Epub 2024 Sep 9.
Alopecia areata is an autoimmune condition characterized by rapid hair loss in the scalp, eyebrows and eyelashes, for which treatments are limited. Baricitinib, an oral inhibitor of Janus kinases 1 and 2, has been recently approved to treat alopecia areata.
We conducted a retrospective study involving 23 medical centres across Italy, enrolling patients affected by severe alopecia areata (SALT >50), for more than 6 months. Clinical and trichoscopic assessment was performed at each visit and impact on quality of life, anxiety and depression were evaluated using the Skindex-16 and the Hospital Anxiety and Depression Scale (HADS), respectively.
A total of 118 patients were enrolled, with a mean age of 39 years and a mean SALT >95. The mean value of the SALT score decreased from an average of 96.6 (±8.23 sd) to 48 (±35.2 sd) after 24 weeks of treatment and 42.3% of patients achieved a SALT 30, 31.3% a SALT 20 and 20.3% a SALT 10 by Week 24. Trichoscopic signs showed fewer yellow dots and black dots significantly earlier than hair regrowth. Adverse events during the treatment period (mild laboratory test abnormalities) were reported in 12.7% patients. No drop-out were registered.
Data on the effectiveness and safety of baricitinib are promising and support the use of this drug in severe forms of AA, also in the early stages. We also suggest performing trichoscopy in order to reveal early response to therapy.
斑秃是一种自身免疫性疾病，其特征是头皮、眉毛和睫毛迅速脱发，治疗方法有限。巴瑞替尼是一种口服的Janus激酶1和2抑制剂，最近已被批准用于治疗斑秃。
我们进行了一项回顾性研究，涉及意大利的23个医疗中心，招募患有严重斑秃（SALT>50）超过6个月的患者。每次就诊时进行临床和毛发镜评估，并分别使用Skindex-16和医院焦虑抑郁量表（HADS）评估对生活质量、焦虑和抑郁的影响。
共招募了118名患者，平均年龄39岁，平均SALT>95。治疗24周后，SALT评分的平均值从平均96.6（±8.23标准差）降至48（±35.2标准差），到第24周时，42.3%的患者SALT达到30，31.3%的患者SALT达到20，20.3%的患者SALT达到10。毛发镜检查显示，黄色小点和黑色小点减少的时间明显早于毛发再生。12.7%的患者报告了治疗期间的不良事件（轻度实验室检查异常）。没有患者退出研究。
巴瑞替尼有效性和安全性的数据很有前景，支持在严重斑秃的早期阶段使用这种药物。我们还建议进行毛发镜检查，以揭示对治疗的早期反应。
