Olumiant / Baricitinib
Olumiant, or baricitinib, is an oral medication approved for rheumatoid arthritis and severe alopecia areata. It’s the sole FDA-approved oral alternative to topical treatments.
As an oral medication, it has the advantage of affecting the entire body, making it suitable for subtypes of alopecia areata, including total body hair loss (alopecia universalis).
Alopecia areata is an autoimmune hair loss condition characterized by circular patches of hair loss, sometimes progressing to complete hair loss.
Olumiant works by blocking immune reactions triggered by cytokines, proteins involved in autoimmune diseases. By reducing immune responses, it allows uninterrupted hair growth.
While relatively new for alopecia, Olumiant is widely used for rheumatoid arthritis, though it’s not yet well-known in many countries, including France.
Is it effective for hair loss?
Concerning its effectiveness in treating hair loss, the FDA approved this medication based on two phase 3 scientific studies conducted by the manufacturer, Eli Lilly, known as the BRAVE-AA1 and BRAVE-AA2 studies.
In these studies, 1,200 volunteers who suffered from alopecia areata and had lost a minimum of 50% of their hair were divided into three groups:
- Group 1: Received 2 mg of Olumiant per day.
- Group 2: Received 4 mg of Olumiant per day.
- Group 3: Received an empty capsule (placebo) per day.
In the first study, the results were quite promising. Approximately 22% of the individuals in the group receiving 2 mg of Olumiant daily saw at least an 80% regrowth of their hair. In the group taking 4 mg per day, this figure rose to 36%. For those in the placebo group, only 5% experienced similar regrowth.
The second study yielded slightly lower results. Here, about 17% of those in the 2 mg Olumiant group achieved at least 80% hair regrowth, while 32% of those in the 4 mg group experienced similar results. In the placebo group, this number was only 3%.
Concluding thoughts and verdict
In my opinion, Olumiant could be a potentially effective treatment for moderate to severe forms of alopecia areata and its subtypes. However, it should be administered with utmost caution and under the supervision of a medical professional. This is because the suppression of immune system functions can carry inherent risks.
It’s important to note that Olumiant is not a suitable treatment for individuals dealing with androgenetic alopecia or telogen effluvium hair loss.
Precautions & Side Effects
This medication should be used under the supervision of a medical professional.
During pregnancy, the use of baricitinib is contraindicated.
Common side effects may include:
- Headaches
- Nausea
- Acne
- Weight gain
- Fatigue
- Stomach discomfort
- Reduced blood cell counts, especially red and white blood cells
- Inflammation of hair follicles
- Elevated cholesterol levels
- Increased levels of liver and muscle enzymes
- Genital, urinary, upper and lower respiratory tract infections
Less common but more severe side effects may include:
- Severe infections, including tuberculosis, shingles, and other bacterial, viral, or fungal infections
- Cancer
- Major cardiovascular events, such as heart attacks and strokes
- Blood clots
- Increased risk of death for individuals aged 50 or older with at least one heart-related risk factor
Olumiant can also lead to other serious side effects that are not listed here, including stomach ulcers and allergic reactions like hives, difficulty breathing, or swelling of the mouth, tongue, or throat.
If you experience any of these serious side effects, it is strongly recommended to seek immediate medical attention.