JAK inhibitors have been used with success for patients with widespread recalcitrant alopecia totalis and universalis. This recent FDA warning confirms for every medication to consider the risk/benefit of the medication prescribbed for the condition it is being used to treat. Alopecia totalis and universalis cause tremendous emotional and psychological stress for many of those with it. If multiple other medications fail, JAK inhibitors can be considered but only after close consultation with the patient's primary MD and patient education of the potential side effects.
https://www.fda.gov/safety/medical-product-safety-information/janus-kinase-jak-inhibitors-drug-safety-communication-fda-requires-warnings-about-increased-risk
