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 a real-world setting. Conducted at Tohoku University Hospital, Japan, it involved 22 patients, with 9 being JAK inhibitor-naïve and 13 having prior baricitinib exposure. Results showed that all JAKi-naïve patients achieved a SALT50 score, indicating a significant reduction in hair loss, with 78% reaching SALT75. In contrast, only 23% of JAKi-experienced patients achieved SALT50, and 8% reached SALT75. No adverse events or worsening of SALT scores were reported, suggesting ritlecitinib is particularly effective for JAKi-naïve patients and remains a viable option for those previously treated with baricitinib due to its safety profile.