Efficacy of Janus Kinase Inhibitors in Alopecia in Jordanian Patients: A Retrospective Cohort Study.

Introduction  Alopecia areata (AA) is an autoimmune disorder causing non-scarring hair loss on the scalp, eyebrows, eyelashes, and other areas. Janus kinase (JAK) inhibitors have emerged as promising treatments, but data on their efficacy in Middle Eastern populations, including Jordanians, are limited. The Severity of Alopecia Tool (SALT) score is commonly used to assess disease severity, while Clinician-Reported Outcome (ClinRO) measures provide additional insights. Aim To evaluate the efficacy of JAK inhibitors in Jordanian AA patients using the SALT score as the primary outcome measure. Methods A retrospective cohort study was conducted at King Hussein Hospital, Jordanian Royal Medical Services, from January 2020 to December 2023. Medical records of AA patients aged ≥18 years treated with JAK inhibitors were reviewed. Data included demographics, disease duration, previous treatments, and adverse effects. Efficacy was assessed by the percentage change in SALT scores at six and 12 months. Statistical analyses included repeated-measures MANCOVA (Multivariate Analysis of Covariance), Chi-square, and independent t-test. A p-value <0.05 was considered significant. Results Our analysis included 57 patients, of which 31 (54.4%) received tofacitinib and 26 (45.6%) received baricitinib. A significantly higher proportion of baricitinib users had treatment durations >12 months (53.8%) compared to tofacitinib users (12.9%), while shorter durations (three to six months) were more common among tofacitinib users (41.9% vs. 15.4%;