Executive summary (what TA926 means in practice)
- Scope: NICE TA926 recommends baricitinib as an option for severe alopecia areata within its marketing authorisation, delivered via specialist pathways.
- Primary care role: recognise severe disease early, document severity/impact, exclude obvious mimics, and refer to dermatology with clear information.
- Eligibility concepts commonly include severity scoring (e.g., SALT) and significant QoL impact; local commissioning criteria apply.
Referral documentation that speeds triage
- Onset and progression timeline; pattern (patchy vs totalis/universalis); eyebrow/beard involvement.
- Photographs (with consent) can help specialist triage.
- QoL impact (work/social functioning, psychological distress) and what support has been offered.
- Any relevant autoimmune history and medications.
Prescribing is specialist-led
Baricitinib is an immunomodulatory medicine with infection, monitoring, and contraindication considerations. Initiation and monitoring are typically under dermatology with local shared-care policies.
Frequently asked questions
Can primary care start baricitinib for alopecia?
No—TA926 positions this via specialist commissioning and monitoring pathways. Primary care can support referral and shared-care where a formal protocol exists.
What’s the most helpful GP contribution?
Early recognition of severe disease and clear documentation of extent and impact to help dermatology prioritise appropriately.
Transparency
This page is an educational, clinician-written summary of publicly available NICE guidance intended for trained healthcare professionals. It uses original wording (not copied text) and should be used alongside the full NICE source, local pathways, and clinical judgement. Doses provided are for general reference; always check the BNF/SPC.