Background:

Alopecia areata (AA) is a common autoimmune condition characterized by patchy non-scarring hair loss. In 2022, baricitinib became the first FDA-approved treatment for severe AA. There is a significant gap in research on whether there is a differential response to baricitinib based on a patient’s race and/or ethnicity. We are undertaking this research project to study whether one’s racial background may play a role in treatment response to baricitinib. 

Objective:

The primary objective of this study is to determine whether there is a differential response to treatment in patients with AA taking baricitinib based on race and/or ethnicity, as evaluated from the time of initiation of baricitinib to up to 18 months of treatment.

Methods:

A retrospective chart review was conducted at UCLA searching for patients > 18 years with a diagnosis of AA who took baricitinib from June 2022 – December 2023. Improvement in hair growth was measured by the percent in change of the patient’s SALT score from baseline to the final SALT score. Analysis was conducted using a mixed effect model on SAS to determine if there is a statistically significant difference in hair improvement based on a patient’s race/ethnicity. Qualitative descriptions of hair loss over time were also used in the final assessment of treatment response. Phone calls were conducted to update medical history and assess patients’ self-perception of hair loss over time.

Results:

The total number of patients who met the inclusion criteria was 86. 10 of the 86 patients were excluded as they reportedly never started baricitinib. Of these 76 patients, 63% of patients identify as Non-hispanic Caucasian, 12% identify as Asian, 9% identify as Hispanic, 8% identify as African American, and 8% identify as other race. 55% of subjects identify as female, whereas 45% identify as male. The average age is 43 +/- 15. Based on preliminary interpretation of SALT scores and documented physical exam findings, 77% of patients showed a strong response in hair re-growth, whereas 23% exhibited a poor response. In Caucasian patients, the overall percent with a strong response was 75%, compared to 83% in patients identifying as African American, Hispanic, or Asian.

Conclusions:

Based on initial data, there does not seem to be a statistically significant difference in hair growth for patients taking baricitinib based on their race and/or ethnicity. We can use this information to effectively target treatment in patients of different racial/ethnic backgrounds, such that we can ultimately achieve optimal health outcomes for all patients.