{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T20:15:28Z","timestamp":1793650528214,"version":"4.5.1"},"reference-count":67,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Alopecia areata (AA) is an autoimmune disease characterized by inflammatory and non-scarring hair loss, mediated by CD8+ T cells and primarily affecting hair follicles. Janus kinase (JAK) inhibitors selectively inhibit JAK, block the signal transducer and activator of transcription pathway, and often interfere with T-cell-mediated inflammatory cytokine pathways. They are a class of targeted anti-inflammatory drugs that can promote the activation of hair follicle stem cells. Studies have shown that JAK inhibitors exhibited good efficacy and safety in the treatment of AA, with fewer serious side effects. This article reviews the mechanism of action of JAK inhibitors in the treatment of AA and the effects and side effects of representative drugs.<\/jats:p>","DOI":"10.3389\/fimmu.2025.1577115","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T05:28:42Z","timestamp":1747114122000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":24,"title":["Janus kinase inhibitors for alopecia areata: a review of clinical data"],"prefix":"10.3389","volume":"16","author":[{"given":"Yutong","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanli","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaling","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.70076","article-title":"Global burden of alopecia areata and associated diseases: a trend analysis from 1990 to 2021","volume":"24","author":"Zhou","year":"2025","journal-title":"J Cosmet Dermatol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.19768","article-title":"European expert consensus statement on the systemic treatment of alopecia areata","volume":"38","author":"Rudnicka","year":"2024","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2023.0002","article-title":"Trends in prevalence and incidence of alopecia Areata, alopecia totalis, and alopecia universalis among adults and children in a US employer-sponsored insured population","volume":"159","author":"Mostaghimi","year":"2023","journal-title":"JAMA Dermatol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jconrel.2024.06.060","article-title":"Nanostructured lipid carriers promote percutaneous absorption and hair follicle targeting of tofacitinib for treating alopecia areata","volume":"372","author":"Li","year":"2024","journal-title":"J Control Release"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1038\/nm.3645","article-title":"Alopecia areata is driven by cytotoxic T lymphocytes and is reversed by JAK inhibition","volume":"20","author":"Xing","year":"2014","journal-title":"Nat Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2019.08.035","article-title":"Frontiers in alopecia areata pathobiology research","volume":"144","author":"Gilhar","year":"2019","journal-title":"J Allergy Clin Immunol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25115652","article-title":"Deciphering the complex immunopathogenesis of alopecia areata","volume":"25","author":"\u0160uti\u0107 Udovi\u0107","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.16808","article-title":"Alopecia areata: a review of disease pathogenesis","volume":"179","author":"Rajabi","year":"2018","journal-title":"Br J Dermatol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.jaut.2018.12.001","article-title":"Alopecia areata: a multifactorial autoimmune condition","volume":"98","author":"Simakou","year":"2019","journal-title":"J Autoimmun"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-023-01873-w","article-title":"Baricitinib for the treatment of alopecia areata","volume":"83","author":"Freitas","year":"2023","journal-title":"Drugs"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2022.e09184","article-title":"Genetic predisposition of alopecia areata in Jordanians: a case-control study","volume":"8","author":"Al-Eitan","year":"2022","journal-title":"Heliyon"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/exd.14129","article-title":"Understanding the significance of cytokines and chemokines in the pathogenesis of alopecia areata","volume":"29","author":"Ito","year":"2020","journal-title":"Exp Dermatol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1111\/exd.14027","article-title":"Allergy promotes alopecia areata in a subset of patients","volume":"29","author":"Zhang","year":"2019","journal-title":"Exp Dermatol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1097\/DER.0000000000000512","article-title":"Reactivation of alopecia areata after dupilumab therapy for atopic dermatitis","volume":"32","author":"Carnicle","year":"2021","journal-title":"Dermatitis"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2023.1281660","article-title":"Gut microbiome, metabolome, and alopecia areata","volume":"14","author":"Liu","year":"2023","journal-title":"Front Microbiol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.15885","article-title":"Analysis of the gut microbiota in alopecia areata: identification of bacterial biomarkers","volume":"34","author":"Moreno-Arrones","year":"2019","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.142205","article-title":"Selective inhibition of JAK3 signaling is sufficient to reverse alopecia areata","volume":"6","author":"Dai","year":"2021","journal-title":"JCI Insight"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.738481","article-title":"Tofacitinib suppresses several JAK-STAT pathways in rheumatoid arthritis in vivo and baseline signaling profile associated with treatment response","volume":"12","author":"Palmroth","year":"2021","journal-title":"Front Immunol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"adv13475","DOI":"10.2340\/actadv.v103.13475","article-title":"Drug survival and long-term outcome of tofacitinib in patients with alopecia areata: a retrospective study","volume":"103","author":"Huang","year":"2023","journal-title":"Acta Derm Venereol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"e15310","DOI":"10.1111\/dth.15310","article-title":"Tofacitinib as a pragmatic treatment choice for alopecia areata: A retrospective review","volume":"35","author":"Benton","year":"2022","journal-title":"Dermatol Ther"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2017.06.027","article-title":"Oral tofacitinib monotherapy in Korean patients with refractory moderate-to-severe alopecia areata: a case series","volume":"77","author":"Park","year":"2017","journal-title":"J Am Acad Dermatol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2016.09.007","article-title":"Tofacitinib for the treatment of severe alopecia areata and variants: a study of 90 patients","volume":"76","author":"Liu","year":"2017","journal-title":"J Am Acad Dermatol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.jaad.2016.09.006","article-title":"Tofacitinib for the treatment of alopecia areata and variants in adolescents","volume":"76","author":"Craiglow","year":"2017","journal-title":"J Am Acad Dermatol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.08.041","article-title":"Tofacitinib for the treatment of alopecia areata in preadolescent children","volume":"80","author":"Craiglow","year":"2019","journal-title":"J Am Acad Dermatol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.12.041","article-title":"Tofacitinib therapy for children with severe alopecia areata","volume":"80","author":"Dai","year":"2019","journal-title":"J Am Acad Dermatol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1016\/j.jaad.2018.02.031","article-title":"Topical 2% tofacitinib for children with alopecia areata, alopecia totalis, and alopecia universalis","volume":"87","author":"Putterman","year":"2022","journal-title":"J Am Acad Dermatol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-023-00764-w","article-title":"Efficacy and safety of baricitinib in patients with severe alopecia areata over 52 weeks of continuous therapy in two phase III trials (BRAVE-AA1 and BRAVE-AA2)","volume":"24","author":"Kwon","year":"2023","journal-title":"Am J Clin Dermatol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-023-00799-z","article-title":"Baricitinib: a review in severe alopecia areata","volume":"24","author":"Fung","year":"2023","journal-title":"Am J Clin Dermatol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1093\/bjd\/ljad118","article-title":"Treatment of moderate-to-severe alopecia areata in pre-adolescent children with baricitinib","volume":"189","author":"Asfour","year":"2023","journal-title":"Br J Dermatol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2022.12.033","article-title":"Treatment of moderate-to-severe alopecia areata in adolescents with baricitinib: a retrospective review of 29 patients","volume":"88","author":"Moussa","year":"2023","journal-title":"J Am Acad Dermatol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1093\/bjd\/ljac059","article-title":"Integrated safety analysis of baricitinib in adults with severe alopecia areata from two randomized clinical trials","volume":"188","author":"King","year":"2023","journal-title":"Br J Dermatol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.18810","article-title":"Systematic review of newer agents for the management of alopecia areata in adults: Janus kinase inhibitors, biologics and phosphodiesterase-4 inhibitors","volume":"37","author":"Gupta","year":"2022","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"e89790","DOI":"10.1172\/jci.insight.89790","article-title":"Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata","volume":"1","author":"Mackay-Wiggan","year":"2016","journal-title":"JCI Insight"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.13598","article-title":"Two cases of alopecia areata treated with ruxolitinib: a discussion of ideal dosing and laboratory monitoring","volume":"56","author":"Vandiver","year":"2017","journal-title":"Int J Dermatol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.08.040","article-title":"Ruxolitinib for the treatment of severe alopecia areata","volume":"80","author":"Liu","year":"2019","journal-title":"J Am Acad Dermatol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2019.10.016","article-title":"Ruxolitinib cream for the treatment of patients with alopecia areata: A 2-part, double-blind, randomized, vehicle-controlled phase 2 study","volume":"82","author":"Olsen","year":"2020","journal-title":"J Am Acad Dermatol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21145137","article-title":"The effect of JAK inhibitor on the survival, anagen re-entry, and hair follicle immune privilege restoration in human dermal papilla cells","volume":"21","author":"Kim","year":"2020","journal-title":"Int J Mol Sci"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2022.03.045","article-title":"Phase 2 randomized, dose-ranging trial of CTP-543, a selective Janus Kinase inhibitor, in moderate-to-severe alopecia areata","volume":"87","author":"King","year":"2022","journal-title":"J Am Acad Dermatol"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2024.06.097","article-title":"Efficacy and safety of deuruxolitinib, an oral selective Janus kinase inhibitor, in adults with alopecia areata: Results from the Phase 3 randomized, controlled trial (THRIVE-AA1)","volume":"91","author":"King","year":"2024","journal-title":"J Am Acad Dermatol"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2024.07.1117","article-title":"54022 pooled safety assessments from the multinational phase 3 THRIVE-AA1 and THRIVE-AA2 trials of deuruxolitinib in adult patients with moderate to severe alopecia areata","volume":"91","author":"King","year":"2024","journal-title":"J Am Acad Dermatol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2024.07.161","article-title":"51840 efficacy of the oral JAK1\/JAK2 inhibitor deuruxolitinib in adult patients with moderate to severe alopecia areata: pooled results from the multinational double-blind, placebo-controlled THRIVE-AA1 and THRIVE-AA2 phase 3 trials","volume":"91","author":"Senna","year":"2024","journal-title":"J Am Acad Dermatol"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2024.07.289","article-title":"54029 pooled patient-reported outcomes from the phase 3 THRIVE-AA1 and THRIVE-AA2 trials of deuruxolitinib in adult patients with moderate to severe alopecia areata","volume":"91","author":"Mesinkovska","year":"2024","journal-title":"J Am Acad Dermatol"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1021\/acschembio.9b00188","article-title":"PF-06651600, a dual JAK3\/TEC family kinase inhibitor","volume":"14","author":"Xu","year":"2019","journal-title":"ACS Chem Biol"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2021.03.050","article-title":"A phase 2a randomized, placebo-controlled study to evaluate the efficacy and safety of the oral Janus kinase inhibitors ritlecitinib and brepocitinib in alopecia areata: 24-week results","volume":"85","author":"King","year":"2021","journal-title":"J Am Acad Dermatol"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00222-2","article-title":"Efficacy and safety of ritlecitinib in adults and adolescents with alopecia areata: a randomised, double-blind, multicentre, phase 2b\u20133 trial","volume":"401","author":"King","year":"2023","journal-title":"Lancet"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2024.09.064","article-title":"Sustained hair regrowth with continued ritlecitinib treatment through week 48 in patients with alopecia areata with or without early target responses: post hoc analysis of the ALLEGRO phase 2b\/3 trial","volume":"92","author":"Piliang","year":"2025","journal-title":"J Am Acad Dermatol"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-023-01928-y","article-title":"Ritlecitinib: first approval","volume":"83","author":"Blair","year":"2023","journal-title":"Drugs"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.25251\/skin.7.supp.291","article-title":"Integrated safety analysis of ritlecitinib for the treatment of alopecia areata (AA) from the phase 2 and phase 3 ALLEGRO clinical trial program","volume":"7","author":"King","year":"2023","journal-title":"SKIN: J Cutan Med"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2021.12.008","article-title":"Maintenance, withdrawal, and re-treatment with ritlecitinib and brepocitinib in patients with alopecia areata in a single-blind extension of a phase 2a randomized clinical trial","volume":"87","author":"Peeva","year":"2022","journal-title":"J Am Acad Dermatol"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2021.10.036","article-title":"Ritlecitinib and brepocitinib demonstrate significant improvement in scalp alopecia areata biomarkers","volume":"149","author":"Guttman-Yassky","year":"2022","journal-title":"J Allergy Clin Immunol"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-021-01638-3","article-title":"Abrocitinib: first approval","volume":"81","author":"Deeks","year":"2021","journal-title":"Drugs"},{"key":"B52","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.jdcr.2022.02.027","article-title":"A case of atopic dermatitis with alopecia universalis in a patient treated with abrocitinib","volume":"22","author":"Zhao","year":"2022","journal-title":"JAAD Case Rep"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1111\/ajd.13836","article-title":"Successful treatment of chronic severe alopecia areata with abrocitinib","volume":"63","author":"Bennett","year":"2022","journal-title":"Australas J Dermatol"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2024.09.025","article-title":"Oral abrocitinib for treatment of refractory alopecia areata: A retrospective study","volume":"92","author":"Zhang","year":"2025","journal-title":"J Am Acad Dermatol"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1111\/cts.13688","article-title":"Upadacitinib: mechanism of action, clinical, and translational science","volume":"17","author":"Mohamed","year":"2024","journal-title":"Clin Transl Sci"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1111\/dth.15346","article-title":"Upadacitinib improved alopecia areata in a patient with atopic dermatitis: a case report","volume":"35","author":"Cantelli","year":"2022","journal-title":"Dermatol Ther"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2022.12.056","article-title":"Treatment of alopecia areata with the janus kinase inhibitor upadacitinib: a retrospective cohort study","volume":"89","author":"Flora","year":"2023","journal-title":"J Am Acad Dermatol"},{"key":"B58","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1136\/ard-2024-226385","article-title":"Ivarmacitinib, a selective Janus kinase 1 inhibitor, in patients with moderate-to-severe active rheumatoid arthritis and inadequate response to conventional synthetic DMARDs: results from a phase III randomised clinical trial","volume":"84","author":"Liu","year":"2025","journal-title":"Ann Rheum Dis"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2023.02.063","article-title":"A randomized, double-blind, placebo-controlled phase II study to evaluate the efficacy and safety of ivarmacitinib (SHR0302) in adult patients with moderate-to-severe alopecia areata","volume":"89","author":"Zhou","year":"2023","journal-title":"J Am Acad Dermatol"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.19797","article-title":"Comparative efficacy of oral Janus kinase inhibitors and biologics in adult alopecia areata: a systematic review and Bayesian network meta-analysis","volume":"38","author":"Husein-ElAhmed","year":"2024","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.19090","article-title":"Adverse events in patients treated with Jak-inhibitors for alopecia areata: a systematic review","volume":"37","author":"Sechi","year":"2023","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B62","doi-asserted-by":"publisher","first-page":"7140","DOI":"10.1038\/s41598-022-10777-w","article-title":"Adverse events associated with JAK inhibitors in 126,815 reports from the WHO pharmacovigilance database","volume":"12","author":"Hoisnard","year":"2022","journal-title":"Sci Rep"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32987-8","article-title":"JAK inhibitors and alopecia areata","volume":"393","author":"Gilhar","year":"2019","journal-title":"Lancet"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-021-08883-0","article-title":"Alopecia areata: an update on etiopathogenesis, diagnosis, and management","volume":"61","author":"Zhou","year":"2021","journal-title":"Clin Rev Allergy Immunol"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2109927","article-title":"Cardiovascular and cancer risk with tofacitinib in rheumatoid arthritis","volume":"386","author":"Ytterberg","year":"2022","journal-title":"N Engl J Med"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2017.31","article-title":"Hypertriglyceridaemia and risk of coronary artery disease","volume":"14","author":"Reiner","year":"2017","journal-title":"Nat Rev Cardiol"},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2022.04.009","article-title":"Phase 3 efficacy and safety of abrocitinib in adults with moderate-to-severe atopic dermatitis after switching from dupilumab (JADE EXTEND)","volume":"87","author":"Shi","year":"2022","journal-title":"J Am Acad Dermatol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1577115\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T05:28:43Z","timestamp":1747114123000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1577115\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,13]]},"references-count":67,"alternative-id":["10.3389\/fimmu.2025.1577115"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2025.1577115","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,13]]},"article-number":"1577115"}}