Patient preferences for treatment characteristics of Janus kinase inhibitors for alopecia areata: a discrete choice experiment

BACKGROUND: Janus kinase inhibitors (JAKis) can improve hair regrowth in alopecia areata (AA). OBJECTIVE: This study examined which treatment attributes patients value most when evaluating hypothetical JAKi-based therapies. METHODS: A discrete choice experiment was conducted among adults with ≥50% hair loss, recruited through the National Alopecia Areata Foundation (February-March 2024). Participants completed 10 binary choices comparing three hypothetical JAKi attributes: proportion with scalp hair regrowth, time to initial hair regrowth, and dosing frequency; safety attributes were held constant across profiles because the safety profiles were similar among JAKis approved for AA. Relative importance (RI) was calculated using preference weights. Additionally, participants ranked three blinded treatment profiles developed from phase 2b-3 data: drug profile A (baricitinib 4 mg), drug profile B (ritlecitinib 50 mg), and drug profile C (deuruxolitinib 8 mg). RESULTS: Among 302 patients (85% women, 81% White, mean age 43.2 years), the most valued attribute was scalp regrowth (RI = 60.0%), followed by time to initial regrowth (28.2%) and dosing frequency (11.7%). Drug profile C was most preferred (83%), and drug profile B was least preferred (85%). CONCLUSION: When considering efficacy only, patients prioritize higher efficacy and faster time to hair regrowth above dosing convenience in JAKi treatment preferences for AA.