Baricitinib convinces in phase 3 study in hair loss

A woman with a white shirt grabs her hair and stands with her back facing the camera.


Circular hair loss is the most common type of hair loss after constitutional hair loss, occurring in 1-2% of the population. Since the exact cause has not yet been proven, there is currently no causal treatment method. Therefore, a recent study analyzed the drug baricitinib against this form of hair loss.

A woman with a white shirt grabs her hair and stands with her back facing the camera.

Element5 Digital

Alopecia areata:

Circular hair loss, technically known as alopecia areata, is one of the autoimmune diseases and can manifest as rapid, non-scarring, patchy hair loss on the scalp, eyebrows and eyelashes. This can be manifested by bald patches to complete hair loss and can register not only physical but also negative psychosocial effects. Currently, there are treatment options that are intended to stimulate hair growth either locally (i.e., locally) or systemically (i.e., affecting the entire body). These include:

  • Skin irritants against circular hair loss (e.g.: anthralin, chrysarobin, capsaicin and pepper tincture)
  • Solutions with the active ingredient minoxidil
  • Creams or solutions with glucocorticoids "cortisone".
  • Topical immunotherapy
  • PUVA (i.e. psoralen plus UV-A, photochemical treatment method).

However, none of these treatments is a causative therapeutic method. In this context, it has been known among dermatologists for several years that a course of so-called Janus kinase inhibitors(JAK for short) could have a positive effect on the disease, which is currently being conducted "off-label". The drug used in the study, baricitinib, is an oral, selective, reversible inhibitor of JAK and can interrupt signaling (i.e., signaling of certain cytokines involved in autoimmune diseases in the lymphocytes), which is significant for the formation of alopecia areata. As a result, immune cells are not activated and the inflammatory response is prevented.

BRAVE studies:

Published in 2022, in the New England Journal of Medicine, the placebo-controlled, randomized, two-part Phase 3 study was conducted in two trials ("BRAVE-AA1" and "BRAVE-AA2") with a total of 1200 study participants. This consisted of adults with severe alopecia areata resulting in hair loss of at least half of the scalp. The severity of the disease was evaluated with a "SALT" (i.e. Severity of Alopecia Tool) score of 0-100, where 0 means no hair loss and 100 means total scalp hair loss. Patients were divided into groups in a 3:2:2 ratio. Either a 4 mg dose of baricitinib, a 2 mg dose, or placebo was administered once daily. The primary end goal was a SALT score of 20 or less at the end of the intervention phase of 36 weeks.

Renewed hair growth:

More than half of the study participants showed a SALT score of 95-100, with about 30% having alopecia universalis, or loss of all body hair. Only 10% of the participants had not attempted any previous therapy. A total of 654 patients participated in the first part, the BRAVE-AA1 study, and 546 patients in the second part, the BRAVE-AA2 study. According to evaluations after 36 weeks, patients recorded a SALT score of 20 or less (i.e., at least 80% scalp hair coverage) as follows:

4 mg baricitinib 2 mg baricitinib


38,8 % 22,8 % 6,2 %


35,9 % 19,4 % 3,3 %

In the first part, the difference between the 4 mg and placebo group was 32.6% and between 2 mg and placebo was 16.6%. The same values for the second part of the study were: 32.6% difference between 4 mg and placebo and 16.1% between 2 mg and placebo.

One third of the patients who received the higher dose experienced renewed hair growth. In the BRAVE-AA2 study, 38.9% of patients on the higher dose experienced renewed hair growth of eyebrows, while 36.8% experienced renewed eyelash growth. Acne, elevated creatine kinase levels, and elevated HDL (about 40% of patients) and LDL cholesterol levels (about 25% of patients) were recorded more frequently in the baricitinib groups than in the placebo group. One patient discontinued the study early because of severe infections.


The oral drug baricitinib used in the two phase 3 trials was significantly superior to the placebo used in terms of renewed hair growth at 36 weeks, according to study results. According to researchers, despite positive results, longer studies are needed to evaluate the efficacy and safety of the drug baricitinib in circular hair loss.

Editorial principles

All information used for the content comes from verified sources (recognised institutions, experts, studies by renowned universities). We attach great importance to the qualification of the authors and the scientific background of the information. Thus, we ensure that our research is based on scientific findings.
Danilo Glisic

Danilo Glisic

As a biology and mathematics student, he is passionate about writing magazine articles on current medical topics. Due to his affinity for facts, figures and data, his focus is on describing relevant clinical trial results.

The content of this page is an automated and high-quality translation from DeepL. You can find the original content in German here.

Last Update





Your personal medicine assistent

afgis-Qualitätslogo mit Ablauf Jahr/Monat: Mit einem Klick auf das Logo öffnet sich ein neues Bildschirmfenster mit Informationen über medikamio GmbH & Co KG und sein/ihr Internet-Angebot: This website is certified by Health On the Net Foundation. Click to verify.

Search our database for drugs, sorted from A-Z with their effects and ingredients.


All substances with their common uses, chemical components and medical products which contain them.


Causes, symptoms and treatment for the most common diseases and injuries.

The contents shown do not replace the original package insert of the medicinal product, especially with regard to dosage and effect of the individual products. We cannot assume any liability for the correctness of the data, as the data was partly converted automatically. A doctor should always be consulted for diagnoses and other health questions. Further information on this topic can be found here.