Baricitinib Selectivity — SCE Dermatology MCQ

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ModerateDermatopharmacologyBaricitinib SelectivitySCE Dermatology

A 40-year-old woman has widespread alopecia areata affecting 60% of her scalp. She has failed intralesional steroids and topical immunotherapy. Her dermatologist starts Baricitinib. What JAK selectivity does Baricitinib have?

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Correct answer: C — JAK1/JAK2 inhibitor

Baricitinib inhibits both JAK1 and JAK2. In alopecia areata, the IFN-gamma/JAK1-JAK2/STAT1 pathway is central to the autoimmune attack on hair follicles. By blocking this signalling axis, Baricitinib prevents the collapse of hair follicle immune privilege. The BRAVE-AA1/AA2 trials used Baricitinib 2 mg and 4 mg doses, demonstrating significant SALT improvement. Monitoring includes FBC, LFTs, lipids, CPK, and screening for latent infections. JAK inhibitor class warnings apply. Hair regrowth is not maintained in most patients after drug cessation, suggesting ongoing treatment is needed — the optimal long-term treatment strategy is still being defined.

Reference: NICE TA875; BAD