Ritlecitinib in Alopecia Areata: A 24-Week Real-World Experience Contrasting JAK Inhibitor-Naïve and JAK Inhibitor-Experienced Patients

This study evaluated the effectiveness of ritlecitinib, a JAK3 and TEC family kinase inhibitor, in treating severe alopecia areata (AA) over 24 weeks in 22 patients at Tohoku University Hospital, Japan. The study included 9 JAK inhibitor-naïve patients and 13 who had previously used baricitinib. Results showed that all JAKi-naïve patients achieved a SALT 50 score, with 78% reaching SALT ≤ 20 and SALT 75. In contrast, only 23% of JAKi-experienced patients achieved SALT 50, and 8% reached SALT 75. No adverse events or worsening of SALT scores were reported. The findings suggest that ritlecitinib is particularly effective in younger, JAKi-naïve patients, while still being a viable option for those previously treated with baricitinib due to its safety profile.