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Introduction <p>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.</p> Methods <p>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.</p> Results <p>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&#xa0;months of barictinib treatment compared with those patients with high TB (<i>p</i> &lt; 0.05). This association was observed independently of all other known progression factors (duration of AA, baseline SALT, total/universal AA, female sex) (<i>p</i> &lt; 0.05).</p> Conclusions <p>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.</p>

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Therapeutic Burden as Predictor of Response to Baricitinib for Alopecia Areata in Real Life: Prospective Study

  • 期刊论文

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  • 发表日期：

    2025年7月7日

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  • Daniel Muñoz-Barba,
  • Alberto Soto-Moreno,
  • Sofía Haselgruber-de Francisco,
  • Manuel Sánchez-Díaz,
  • Salvador Arias-Santiago

摘要

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.