Ritlecitinib for Severe Alopecia Areata: A 24-Week, Multicentre, Real-World Study

March 2026 in “ American Journal of Clinical Dermatology ”

Michela Starace, Luca Rapparini, Francesca Pampaloni, Stephano Cedirian, Federico Quadrelli, Francesca Bruni, Ginevra Martelli, Giampiero Girolomoni, Francesco Bellinato, Paolo Gisondi, Giuseppe Gallo, Simone Ribero, Michela Ortoncelli, Pietro Quaglino, Luigi Gargiulo, Carlo Alberto Vignoli, Alessandra Narcisi, Francesca Ambrogio, Caterina Foti, Raffaele Dante Caposiena, Iris Zalaudek, Angelo Valerio Marzano, Andrea Sechi, Mauro Barbareschi, Luca Valtellini, Silvia Mariel Ferrucci, Laura Diluvio, Enrico Matteini, Luca Bianchi, Mariateresa Cantelli, Paola Nappa, Carolina D’Elia, Valeria Boccaletti, Carola Romanò, Elisabetta Fulgione, Anna Balato, Giuseppe Argenziano, Emanuele Trovato, Elisa Cinotti, Pietro Rubegni, Federica Dall’Oglio, Francesco Lacarrubba, Giuseppe Micali, Elena Pezzolo, Francesca Caroppo, Anna Belloni Fortina, Giacomo Caldarola, Ketty Peris, Lorenzo Maria Pinto, Calogero Pagliarello, Riccardo Balestri, Carlo Tomasini, Stefania Barruscotti, Laura Atzori, Silvia Sanna, Lorenzo Ala, Giulio Bortone, Giovanni Pellacani, Alfredo Rossi, Serena Lembo, Annunziata Raimondo, Flavia Manzo Margiotta, Valentina Dini, Marco Romanelli, Andrea Megna, Francesca Prignano, Gianmarco Silvi, Oriana Simonetti, Edoardo De Simoni, Michela Magnano, Natale Schettini, ⁠⁠Alessandro Borghi, Francesca Satolli, Maria Beatrice De Felici Del Giudice, Franco Rongioletti, Stefania Guida, Gianmarco Diego Bigotto, Cesare Filippeschi, Teresa Oranges, Greta Tronconi, Bianca Maria Piraccini

ritlecitinib alopecia areata Severity of Alopecia Tool SALT score trichoscopic signs hair regrowth eyebrows eyelashes nails acne headache anaemia

Studysummary In this Italian retrospective study, ritlecitinib 50 mg/day showed effectiveness and good tolerability for treating severe alopecia areata over 24 weeks, achieving significant hair regrowth particularly in adolescents, as well as improvements in eyebrows, eyelashes, nails, and quality of life, with mostly mild adverse effects.

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In a 24-week multicentre study in Italy, ritlecitinib 50 mg/day was tested on 102 patients aged 12 and older with severe alopecia areata. The study found that 40.2% of patients experienced significant hair regrowth, with adolescents responding better (48.6%) than adults (21.9%). The mean Severity of Alopecia Tool (SALT) score improved from 86.2 to 40.8, and improvements were noted in trichoscopic signs, quality of life, and hair regrowth on eyebrows, eyelashes, and nails. The treatment was generally well tolerated, with mild adverse events like acne and headache, and only one severe case of anaemia. Overall, ritlecitinib was effective and safe, particularly for adolescents.

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Research cited in this study

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research Real-World Assessment of Ritlecitinib in Patients with Severe Alopecia Areata: A 24-Week Multicentre Retrospective Study

3 citations , July 2025 in “Clinical and Experimental Dermatology”

This study reported that patients with alopecia areata treated with ritlecitinib in a real-life setting had a higher rate of positive response on the Severity of Alopecia Tool score compared to those in the ALLEGRO trial.

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4 citations , October 2024 in “American Journal of Clinical Dermatology”

This study found that ritlecitinib improved patient-reported outcomes related to hair growth in individuals with alopecia areata, with some experiencing clinically meaningful hair regrowth, although changes in emotional symptoms and activity limitations were minimal and similar across treatment groups.

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7 citations , September 2024 in “The Journal of Dermatology”

This study evaluated the effectiveness and safety of ritlecitinib in patients aged 12 or older with alopecia totalis or universalis, finding higher hair regrowth response rates compared to placebo at 24 weeks, with continued improvement and acceptable safety through 48 weeks.

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September 2024 in “Journal of the European Academy of Dermatology and Venereology”

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This study supports the use of a national registry as an effective tool for documenting epidemiological data, disease progression, treatment responses, and quality of life impacts in patients with alopecia areata.

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research Integrated Safety Analysis of Ritlecitinib, an Oral JAK3/TEC Family Kinase Inhibitor, for the Treatment of Alopecia Areata from the ALLEGRO Clinical Trial Program

January 2024 in “American journal of clinical dermatology”

This study reports that ritlecitinib, when used for up to 24 months in patients aged 12 and older with alopecia areata, has an acceptable safety profile, with a similar proportion of adverse events in both ritlecitinib and placebo groups in the placebo-controlled cohort.

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4 citations , January 2024 in “JEADV. Journal of the European Academy of Dermatology and Venereology/Journal of the European Academy of Dermatology and Venereology”

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84 citations , August 2023 in “Drugs”

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This source reports that the approval of baricitinib and ritlecitinib, which are JAK inhibitors, has marked a significant advancement in treating severe alopecia areata (AA), and suggests that additional treatments with new mechanisms may further improve patient outcomes in the future.

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48 citations , July 2023 in “Pediatric Dermatology”

This study found that among adolescents with alopecia areata and significant hair loss, treatment with ritlecitinib resulted in greater hair regrowth and self-reported improvement compared to placebo over 48 weeks, with common side effects including headache, acne, and nasopharyngitis.

Scalp Hair Regrowth Is Associated With Improvements in Health-Related Quality of Life and Psychological Symptoms in Patients With Severe Alopecia Areata: Results From Two Randomized Controlled Trials

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This study found that patients with severe alopecia areata who experienced meaningful scalp hair regrowth showed greater improvements in health-related quality of life and reduced anxiety and depression compared to those with no or minimal regrowth.

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227 citations , April 2023 in “The Lancet”

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