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What type of medications are systemic JAK inhibitors classified as in the treatment of alopecia areata?
What type of medications are systemic JAK inhibitors classified as in the treatment of alopecia areata?
Which of the following has NOT been identified as a serious risk associated with JAK1 inhibitors?
Which of the following has NOT been identified as a serious risk associated with JAK1 inhibitors?
In children aged 12 years and older, which JAK inhibitor is currently the only EMA-approved treatment?
In children aged 12 years and older, which JAK inhibitor is currently the only EMA-approved treatment?
What was a significant basis for the warnings issued regarding systemic JAK inhibitors?
What was a significant basis for the warnings issued regarding systemic JAK inhibitors?
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Which of these statements is true regarding the use of baricitinib and ritlecitinib in adults?
Which of these statements is true regarding the use of baricitinib and ritlecitinib in adults?
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What was the population focus in the studies that led to warnings about JAK1 inhibitors?
What was the population focus in the studies that led to warnings about JAK1 inhibitors?
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How are systemic JAK inhibitors categorized in terms of their effectiveness for alopecia areata?
How are systemic JAK inhibitors categorized in terms of their effectiveness for alopecia areata?
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Which of the following medications is NOT classified as a JAK1 inhibitor?
Which of the following medications is NOT classified as a JAK1 inhibitor?
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What is one hypothesis regarding the loss of immune privilege in alopecia areata?
What is one hypothesis regarding the loss of immune privilege in alopecia areata?
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Which immune cells are mentioned as infiltrating hair follicles in alopecia areata?
Which immune cells are mentioned as infiltrating hair follicles in alopecia areata?
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What characterizes the immune response in the hair follicles of individuals with alopecia areata?
What characterizes the immune response in the hair follicles of individuals with alopecia areata?
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What is a potential systemic cause of immune privilege loss in alopecia areata?
What is a potential systemic cause of immune privilege loss in alopecia areata?
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What is the role of immune privilege in normal hair follicles?
What is the role of immune privilege in normal hair follicles?
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What is the cause of the 'swarm of bees' effect in alopecia areata?
What is the cause of the 'swarm of bees' effect in alopecia areata?
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Which of the following is NOT mentioned as a hypothesis for immune privilege loss in alopecia areata?
Which of the following is NOT mentioned as a hypothesis for immune privilege loss in alopecia areata?
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What condition is associated with the loss of immune privilege described in the provided content?
What condition is associated with the loss of immune privilege described in the provided content?
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What SALT score indicates clinically meaningful improvement for patients with at least 50% scalp hair loss?
What SALT score indicates clinically meaningful improvement for patients with at least 50% scalp hair loss?
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In the BRAVE-AA2 study, what proportion of patients treated with baricitinib 4 mg achieved a SALT score ≤ 20 by Week 52?
In the BRAVE-AA2 study, what proportion of patients treated with baricitinib 4 mg achieved a SALT score ≤ 20 by Week 52?
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Which of the following best represents the treatment response rate for baricitinib 2 mg in the BRAVE-AA1 trial at Week 52?
Which of the following best represents the treatment response rate for baricitinib 2 mg in the BRAVE-AA1 trial at Week 52?
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What does a ClinRO score of 0 indicate regarding eyebrow or eyelash coverage?
What does a ClinRO score of 0 indicate regarding eyebrow or eyelash coverage?
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What was the proportion of patients achieving a ClinRO Measure for Eyebrow Hair Loss of 0 or 1 with a ≥2-point improvement from baseline in the study?
What was the proportion of patients achieving a ClinRO Measure for Eyebrow Hair Loss of 0 or 1 with a ≥2-point improvement from baseline in the study?
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Which of the following is a characteristic of a SALT score ≤ 20?
Which of the following is a characteristic of a SALT score ≤ 20?
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What percentage of patients achieved a SALT score ≤ 20 when treated with baricitinib 2 mg in the BRAVE-AA2 trial at Week 52?
What percentage of patients achieved a SALT score ≤ 20 when treated with baricitinib 2 mg in the BRAVE-AA2 trial at Week 52?
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Which of the following is true regarding the trends in response rates for baricitinib treatment over 52 weeks?
Which of the following is true regarding the trends in response rates for baricitinib treatment over 52 weeks?
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What was the primary outcome measure used to assess the efficacy of Baricitinib in patients with severe alopecia areata?
What was the primary outcome measure used to assess the efficacy of Baricitinib in patients with severe alopecia areata?
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What was the observed proportion of Week-52 responders achieving at least a 2-point improvement in the Measure for Eyelashes™ score from baseline by Week 104?
What was the observed proportion of Week-52 responders achieving at least a 2-point improvement in the Measure for Eyelashes™ score from baseline by Week 104?
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Which Baricitinib dosage had a slightly higher percentage of patients achieving ≥2-point improvement from baseline at Week 104?
Which Baricitinib dosage had a slightly higher percentage of patients achieving ≥2-point improvement from baseline at Week 104?
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During which weeks were the efficacy results for Baricitinib measured?
During which weeks were the efficacy results for Baricitinib measured?
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How many patients were evaluated in the Baricitinib 4 mg group at Week 104?
How many patients were evaluated in the Baricitinib 4 mg group at Week 104?
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What percentage of the Week-52 mixed responders achieved a PRO Measure for Eyelashes™ score of 0 or 1?
What percentage of the Week-52 mixed responders achieved a PRO Measure for Eyelashes™ score of 0 or 1?
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What do the results suggest about the long-term efficacy of Baricitinib for patients with alopecia areata?
What do the results suggest about the long-term efficacy of Baricitinib for patients with alopecia areata?
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What key aspect differentiates Week-52 responders from Week-52 mixed responders in this study?
What key aspect differentiates Week-52 responders from Week-52 mixed responders in this study?
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What trend is observed from Week 52 to Week 104 in the efficacy of Baricitinib?
What trend is observed from Week 52 to Week 104 in the efficacy of Baricitinib?
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Which group had the least number of participants evaluated at Week 104?
Which group had the least number of participants evaluated at Week 104?
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What percentage of patients receiving Baricitinib 2 mg achieved a ≥2-point improvement from baseline after 52 weeks?
What percentage of patients receiving Baricitinib 2 mg achieved a ≥2-point improvement from baseline after 52 weeks?
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What was the proportion of Week-52 responders who achieved a ≥2-point improvement from baseline?
What was the proportion of Week-52 responders who achieved a ≥2-point improvement from baseline?
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Which group had a higher proportion of patients achieving a ≥2-point improvement from baseline at Week 52?
Which group had a higher proportion of patients achieving a ≥2-point improvement from baseline at Week 52?
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At what week was the Hair Assessment PRO™ score assessment evaluated for the percentages provided?
At what week was the Hair Assessment PRO™ score assessment evaluated for the percentages provided?
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What is the Hair Assessment PRO™ score indicating a complete response after treatment?
What is the Hair Assessment PRO™ score indicating a complete response after treatment?
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What percentage of patients in the Week-52 Mixed Responders group achieved a ≥2-point improvement from baseline?
What percentage of patients in the Week-52 Mixed Responders group achieved a ≥2-point improvement from baseline?
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Which of the following is the lowest percentage of improvement reported in the content?
Which of the following is the lowest percentage of improvement reported in the content?
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How many patients were assessed for Baricitinib 4 mg in the study?
How many patients were assessed for Baricitinib 4 mg in the study?
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What is the common measurement used to evaluate hair improvement in this study?
What is the common measurement used to evaluate hair improvement in this study?
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What percentage of patients receiving Baricitinib 4 mg had an improvement at the final assessment?
What percentage of patients receiving Baricitinib 4 mg had an improvement at the final assessment?
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Study Notes
Long-Term Efficacy of Baricitinib for Alopecia Areata
- Study evaluates the long-term effects of baricitinib in patients with severe alopecia areata over 104 weeks, part of the BRAVE-AA1 and BRAVE-AA2 trials.
- Significant proportion of patients achieved a Patient-Reported Outcome (PRO) Measure for Eyelashes™ score of 0 or 1 (≥2-point improvement from baseline) from Week 52 through 104.
- Results for Week-52 responders showed 74.2% with 4 mg baricitinib and 70.4% with 2 mg, while mixed responders showed 67.9% and 58.0% respectively.
Safety Profile of JAK Inhibitors
- Systemic JAK inhibitors, including baricitinib, carry FDA warnings about risks of serious cardiovascular events, cancer, blood clots, and mortality.
- Warnings derived from studies focused on rheumatoid arthritis patients with cardiac risk factors versus TNF inhibitors, emphasizing JAK inhibitors' increased risk.
Approval Status and Treatment Recommendations
- JAK inhibitors are the only officially approved medications for alopecia areata, considered first-line therapy.
- No preference for baricitinib or ritlecitinib in adults; ritlecitinib is currently the only EMA-approved treatment for children aged 12 and older.
Immune Privilege in Alopecia Areata
- The loss of immune privilege in alopecia areata (AA) remains not fully understood; two primary hypotheses include local hair follicle defects due to oxidative stress and systemic immune dysregulation.
- Immune cells penetrate hair follicles in AA, disrupting normal protection mechanisms.
Efficacy Outcomes
- Proportions of patients achieving a Severity of Alopecia Tool (SALT) score ≤20 (≤20% scalp hair loss) increased significantly during treatment.
- At Week 52, response rates for baricitinib were 40.9% (4 mg) and 21.2% (2 mg) in BRAVE-AA1, and 36.8% (4 mg) and 24.4% (2 mg) in BRAVE-AA2.
Eyebrow and Eyelash Response
- Eyebrow and eyelash response rates also improved significantly after 52 weeks of treatment, with Clinician-Reported Outcome (ClinRO) scores showing positive results in both trial arms.
- Proportion of patients achieving a score of 0 (full coverage) or 1 (minimal gaps) for eyebrow hair loss increased notably through the treatment period.
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Description
This quiz focuses on the safety profile of systemic JAK inhibitors for treating alopecia areata. It discusses FDA recommendations and concerns regarding heart-related events, cancer, and blood clots associated with these medications. Understand the implications of these warnings for patient care.
