Systematic Review and Indirect Treatment Comparisons of Ritlecitinib Against Baricitinib in Alopecia Areata

This systematic review compared the efficacy and safety of ritlecitinib 50 mg and baricitinib (2 mg and 4 mg) for treating severe alopecia areata. The study found that ritlecitinib 50 mg and baricitinib 4 mg have similar efficacy in promoting hair regrowth, but ritlecitinib 50 mg was more effective than baricitinib 2 mg, particularly for achieving a Severity of Alopecia Tool (SALT) score of ≤20. Ritlecitinib 50 mg also showed a higher probability of being more effective than baricitinib 2 mg for SALT ≤10 at Week 24. Safety outcomes indicated that baricitinib 4 mg had a higher rate of common adverse events, while ritlecitinib 50 mg was favored for serious adverse events and discontinuation due to adverse events. The study, which included four randomized controlled trials, highlights the potential of ritlecitinib as a more effective treatment option, especially compared to the lower dose of baricitinib, but also notes the need for further research due to high uncertainty and wide confidence intervals.