Alopecia areata: Ritlecitinib generates substantial re-growth of scalp hair

Excluding severe AA, 83–93% of participants in the ALLEGRO-LT trial reached an 80% re-growth of scalp hair or more after 15 months of treatment.

A continuous decrease in SALT score as of month 1

A post-hoc data analysis of the ongoing, open-label, phase 3 ALLEGRO-LT study (NCT04006457) evaluated the oral JAK3/TEC family kinase inhibitor ritlecitinib for success in inducing hair growth in patients with AA. Besides roll-over participants from phase 2 and 3 trials, new patients with ≥12 years of AA-induced scalp hair loss ≥25% were eligible for inclusion. This resulted in an analysed study population of 449 participants with a mean age of 32.9 years, 64.4% women, and a mean SALT score of 74.5. The participants were analysed in 5 different groups of SALT severity at baseline, the most severe group comprising only participants with a SALT score of 95 to 100, the latter defined as total loss of scalp hair.

The results showed a continuous decrease in SALT as of month 1, with all but the most severe group attaining a median SALT between 1.0 and 2.4 at month 15. The group starting with SALT 95–100, achieved a score of 30.9. The assessment of those with at least 80% (SALT20) and 90% (SALT10) re-growth of hair resulted in a similar picture: SALT20 was reached by 83.3–93.0%, SALT10 by 73.5–81.0%, apart from the most severe group who achieved between 43.9% and 33.5%, respectively.

Adverse event-induced study or ritlecitinib discontinuation was observed in 4.9% of patients. “There were no new symptoms or signs reported, so it seems to be a relatively safe drug,” Dr Athanasios Tsianakas (Fachklinik Bad Bentheim, Germany) summarised the safety data on ritlecitinib.

In his conclusions, Dr Tsianakas suggested keeping in mind that starting treatment at more advanced stages of AA could make success more difficult.

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  1. Tsianakas A. Efficacy of ritlecitinib in patients with alopecia areata by extent of hair loss at baseline: post hoc analysis of the phase 3 long-term ALLEGRO-LT study. FC01.1, EADV Congress 2023, 11–14 October, Berlin, Germany.