Baricitinib and tocilizumab — two drugs that became household names during the worst of the COVID-19 pandemic — are now being repurposed to treat conditions ranging from severe hair loss to autoimmune lung disease to the lingering effects of Long COVID. These medications, originally deployed to tame the dangerous immune overreaction known as a cytokine storm, have proven so effective at modulating inflammation that researchers and clinicians are finding new applications for them at a remarkable pace. The story is straightforward but significant: the same molecular pathways that drive a fatal COVID cytokine storm also underlie dozens of chronic inflammatory and autoimmune diseases.
Baricitinib, a JAK 1/2 inhibitor sold as Olumiant, received FDA Emergency Use Authorization during the pandemic for hospitalized COVID patients and has since earned FDA approval for severe alopecia areata, with clinical trials now underway for HIV reservoir reduction and Long COVID. Tocilizumab, an IL-6 receptor blocker marketed as Actemra, expanded from its COVID indication to treat cytokine release syndrome caused by CAR-T cancer therapy, systemic sclerosis-associated interstitial lung disease, and several forms of arthritis. For readers interested in brain health and dementia care, the implications are worth paying attention to — chronic neuroinflammation is increasingly recognized as a driver of cognitive decline, and drugs that quiet systemic inflammation may eventually have a role to play in neuroprotection. This article covers how these cytokine storm drugs work, where they are being used today beyond COVID, what the latest 2026 research reveals, the practical realities of access and drug shortages, and what this wave of repurposing might mean for patients with inflammatory and neurological conditions.
Table of Contents
- How Do Cytokine Storm Drugs From COVID Work Against Other Diseases?
- Baricitinib’s Expansion Into Alopecia, Long COVID, and HIV Research
- Tocilizumab’s Growing Role From Cancer Therapy to Pediatric COVID Care
- What the Biosimilar Wave Means for Patient Access and Cost
- Drug Shortages and the Reality of Relying on Repurposed Medications
- Emerging Research — New Screening Models and Combination Therapies
- What This Means for Brain Health and Neuroinflammation Research
- Conclusion
- Frequently Asked Questions
How Do Cytokine Storm Drugs From COVID Work Against Other Diseases?
A cytokine storm occurs when the immune system floods the body with inflammatory signaling proteins — cytokines — to the point where they begin damaging healthy tissue rather than fighting infection. During COVID-19, this runaway immune response was responsible for the organ failure and deaths that overwhelmed hospitals worldwide. The drugs used to treat it work by interrupting specific points in the inflammatory cascade. Baricitinib blocks the JAK/STAT signaling pathway, which serves as a central relay for multiple pro-inflammatory cytokines. Tocilizumab takes a different approach, blocking the receptor for interleukin-6, one of the most potent inflammatory signals in the body. What makes these drugs valuable beyond COVID is that the JAK/STAT and IL-6 pathways are not unique to coronavirus infection.
They are deeply involved in rheumatoid arthritis, lupus, graft-versus-host disease, and many other conditions where the immune system turns on the body. Think of it this way: COVID did not create new drugs so much as it created an urgent, large-scale testing ground for anti-inflammatory agents that already existed or were in early development. The pandemic compressed years of clinical experience into months, generating safety and efficacy data that would have taken far longer to accumulate under normal circumstances. The comparison between the two drugs matters for clinicians making treatment decisions. Baricitinib is a small molecule taken orally, which makes it convenient but also means it affects multiple JAK-mediated pathways simultaneously — a broader but less targeted approach. Tocilizumab is a monoclonal antibody administered by infusion or injection, offering more precise targeting of IL-6 but requiring clinical settings for administration. Each has trade-offs in terms of specificity, convenience, side effects, and cost, and the choice between them depends heavily on the condition being treated.
Baricitinib’s Expansion Into Alopecia, Long COVID, and HIV Research
The most visible post-COVID success story for baricitinib is in severe alopecia areata, a condition in which the immune system attacks hair follicles, causing dramatic and often devastating hair loss. The FDA approved baricitinib for adults with severe alopecia areata in 2022, and the results in younger patients have been striking. In the Phase 3 BRAVE-AA-PEDS trial, 71% of adolescents with severe disease treated with baricitinib 4 mg achieved successful scalp hair regrowth at one year, while 64.8% saw significant eyebrow regrowth and 63.3% experienced eyelash regrowth. In February 2026, the European Medicines Agency’s CHMP issued a positive opinion recommending Olumiant for adolescents ages 12 to 17 with severe alopecia areata, with a US FDA decision expected in the second half of 2026. However, baricitinib is not a cure for alopecia areata — it is a management tool. Patients who discontinue the drug often see their hair loss return, which means long-term use may be necessary.
This introduces concerns about sustained immunosuppression, including increased risk of infections, blood clots, and cardiovascular events. For patients weighing their options, the decision to start baricitinib for a non-life-threatening condition like hair loss requires honest conversation with a physician about these risks. The drug’s reach extends further than dermatology. Three Phase II clinical trials are currently testing baricitinib as an adjunctive therapy alongside antiretroviral treatment for HIV, with the goal of reducing the viral reservoir and chronic inflammation that persists even when the virus is well controlled. Results are expected by 2028. Meanwhile, baricitinib is being investigated for Long COVID patients whose symptoms resemble autoimmune disease — a condition some researchers describe as a cytokine storm that never fully ended. Additional conditions under investigation include systemic lupus erythematosus, psoriasis, atopic dermatitis, interferon-mediated autoinflammatory diseases, graft-versus-host disease, and diabetic kidney disease.
Tocilizumab’s Growing Role From Cancer Therapy to Pediatric COVID Care
Tocilizumab’s journey beyond COVID has been equally eventful. On August 8, 2025, the FDA approved Actemra for hospitalized pediatric COVID patients ages two and older who are receiving systemic corticosteroids and requiring supplemental oxygen or mechanical ventilation. While COVID hospitalizations have declined significantly, the pediatric approval matters because children who do develop severe disease now have an evidence-backed treatment option. Perhaps more consequential is tocilizumab’s role in cancer immunotherapy. CAR-T cell therapy — in which a patient’s own immune cells are engineered to attack cancer — can trigger a dangerous cytokine release syndrome that looks remarkably similar to a COVID cytokine storm.
Tocilizumab is approved for treating this CRS in adults and pediatric patients aged two and older. The arrival of biosimilars is expanding access to this treatment. In January 2025, a tocilizumab biosimilar called tocilizumab-anoh, marketed as Avtozma, was approved and received an expanded CRS indication, with availability expected by August 31, 2025. The full list of tocilizumab’s current approved indications now includes rheumatoid arthritis, systemic juvenile idiopathic arthritis, polyarticular juvenile idiopathic arthritis, giant cell arteritis, cytokine release syndrome, COVID-19, and systemic sclerosis-associated interstitial lung disease. For a single drug, this breadth of application across conditions from pediatric autoimmune disease to cancer treatment side effects to adult lung fibrosis is unusual and speaks to just how central the IL-6 pathway is to human inflammatory disease.
What the Biosimilar Wave Means for Patient Access and Cost
One of the most practical developments for patients is the surge in biosimilar approvals. The first quarter of 2025 alone saw 10 new biosimilar approvals from the FDA, including multiple Actemra biosimilars. This competition is expected to increase access and lower costs for patients who depend on tocilizumab and similar biologics. The trade-off, however, is familiarity and trust. Patients who have been stable on a brand-name biologic are sometimes reluctant to switch to a biosimilar, and some clinicians share that caution — not because biosimilars are inferior, but because individual patients can respond differently to formulation changes.
The FDA’s biosimilar approval pathway requires rigorous demonstration of equivalence, and real-world data consistently shows comparable outcomes. Still, patients making the switch should do so under clinical guidance, with monitoring during the transition period. For families managing dementia care costs alongside other chronic conditions, the financial implications are meaningful. Biologic drugs can run thousands of dollars per infusion, and biosimilar competition historically drives prices down by 30% or more over time. If a loved one with rheumatoid arthritis or giant cell arteritis is on tocilizumab, asking their rheumatologist about biosimilar options is a reasonable conversation to have.
Drug Shortages and the Reality of Relying on Repurposed Medications
There is a significant caveat to the optimism around drug repurposing: baricitinib is currently experiencing supply shortages in 2026, impacting patients across multiple conditions. When a drug gains new indications and its patient population expands, manufacturing capacity does not always keep pace. Patients who were already taking baricitinib for rheumatoid arthritis may find their supply disrupted as demand increases from alopecia areata patients and clinical trial participants. This shortage illustrates a broader vulnerability in the repurposing model.
Unlike a new drug developed specifically for a single condition with manufacturing scaled accordingly, a repurposed drug can face sudden demand spikes from multiple disease populations simultaneously. Patients who depend on baricitinib should maintain open communication with their pharmacist and prescribing physician about supply status, and should not abruptly discontinue the drug without medical guidance — sudden withdrawal from a JAK inhibitor can trigger disease flares. For caregivers managing complex medication regimens for someone with dementia or other neurological conditions, this is a reminder to keep a buffer supply when possible and to have contingency conversations with the care team before a shortage becomes a crisis. Some specialty pharmacies offer waitlist notifications, and pharmaceutical company patient assistance programs may have reserved supplies.
Emerging Research — New Screening Models and Combination Therapies
The pipeline of cytokine storm treatments continues to expand. A January 2026 study developed a novel in vitro model using lymphoblastoid cell lines for cytokine storm drug screening and found that ciclesonide and acalabrutinib suppressed all measured cytokines by more than 60%, while baricitinib significantly reduced specific inflammatory markers. This type of screening platform could accelerate the identification of existing drugs that might be repurposed for inflammatory conditions, including neuroinflammatory diseases relevant to dementia research.
Separately, St. Jude Research has developed a patented drug combination, designated SJ-21-0008, specifically designed for treating cytokine storms across COVID-19 and other conditions. The combination therapy is available for licensing, suggesting that the next generation of anti-cytokine treatments may involve strategic drug pairings rather than single agents — an approach that could improve efficacy while allowing lower doses of individual drugs and potentially reducing side effects.
What This Means for Brain Health and Neuroinflammation Research
The repurposing of cytokine storm drugs has implications that extend beyond the conditions currently in clinical trials. Neuroinflammation — the chronic, low-grade activation of immune cells in the brain — is increasingly recognized as both a consequence and a driver of Alzheimer’s disease, vascular dementia, and other neurodegenerative conditions. The IL-6 and JAK/STAT pathways that baricitinib and tocilizumab target are active in the central nervous system, and elevated levels of inflammatory cytokines in cerebrospinal fluid correlate with faster cognitive decline in multiple studies. No cytokine storm drug is currently approved or in late-stage trials specifically for dementia.
That is an important caveat. But the safety and dosing data generated by the COVID experience and subsequent repurposing efforts lower the barrier to designing and funding neuroinflammation trials. If baricitinib proves effective for Long COVID cognitive symptoms — the brain fog and memory difficulties that overlap substantially with early dementia presentations — it could open a research pathway that would have been far more difficult to pursue without the pandemic’s accidental contribution to anti-inflammatory pharmacology. The coming years will clarify whether these drugs can cross the blood-brain barrier effectively enough and whether their systemic immunosuppression can be tolerated long-term in elderly patients who are already vulnerable to infection.
Conclusion
The COVID-19 pandemic, for all its devastation, produced an extraordinary natural experiment in anti-inflammatory pharmacology. Baricitinib and tocilizumab, pressed into service against cytokine storms in 2020 and 2021, have since found legitimate roles in treating severe alopecia areata, CAR-T therapy complications, autoimmune lung disease, and potentially Long COVID and HIV. The biosimilar wave is making tocilizumab more accessible, while emerging research continues to identify new candidates for cytokine modulation. These are not theoretical developments — they are changing treatment options for patients right now.
For those navigating brain health concerns and dementia care, the takeaway is cautiously hopeful. The same inflammatory pathways being targeted by these repurposed drugs are implicated in neurodegeneration, and the safety data accumulating from their broadened use could accelerate neuroinflammation research. In the meantime, patients currently taking baricitinib should be aware of ongoing supply shortages, and anyone considering these medications for new indications should have thorough risk-benefit conversations with their physicians. The science is moving quickly, but individual treatment decisions still require careful, personalized judgment.
Frequently Asked Questions
What is a cytokine storm, and why were drugs needed to treat it during COVID?
A cytokine storm is a severe immune overreaction in which the body releases excessive inflammatory proteins that begin damaging healthy organs instead of fighting infection. During COVID-19, this response caused lung damage, organ failure, and death in severe cases, prompting emergency use of anti-inflammatory drugs like baricitinib and tocilizumab.
Is baricitinib approved for conditions other than COVID?
Yes. Baricitinib is FDA-approved for rheumatoid arthritis and severe alopecia areata in adults. The European Medicines Agency recommended approval for adolescents with severe alopecia areata in February 2026, and a US FDA decision for adolescents is expected in the second half of 2026. Clinical trials are also underway for HIV, Long COVID, lupus, and several other inflammatory conditions.
Are tocilizumab biosimilars as effective as the brand-name Actemra?
The FDA’s biosimilar approval pathway requires rigorous evidence of equivalent safety and efficacy. Real-world data supports comparable outcomes. However, patients switching from Actemra to a biosimilar should do so under physician supervision, with monitoring during the transition.
Could these anti-inflammatory drugs eventually be used for Alzheimer’s or dementia?
No cytokine storm drug is currently approved or in late-stage trials for dementia. However, the inflammatory pathways these drugs target — particularly IL-6 and JAK/STAT signaling — are active in the brain and associated with cognitive decline. Research into their potential neuroprotective effects may benefit from the extensive safety data generated during and after the pandemic.
Is there a baricitinib shortage, and what should patients do?
Baricitinib is experiencing supply shortages in 2026 as demand has increased across multiple approved and investigational uses. Patients should stay in close contact with their pharmacist and prescribing physician, avoid abruptly stopping the medication without medical guidance, and ask about patient assistance programs that may have reserved supplies.
What new cytokine storm treatments are being developed?
A January 2026 study identified ciclesonide and acalabrutinib as promising candidates that suppressed measured cytokines by over 60% in a new screening model. St. Jude Research has also developed a patented drug combination specifically targeting cytokine storms, available for licensing to pharmaceutical companies.
