Ritlecitinib for Severe Alopecia Areata: Does Regional Prescribing Match National Guidance?

Ritlecitinib was approved by NICE in March 2024 for treating severe alopecia areata (AA), with supplementary guidance from the British Hair and Nail Society and the BAD. A retrospective audit across six regional dermatology centers evaluated if ritlecitinib prescribing aligned with this guidance. The study included 57 patients, all with severe AA, with some reclassified from moderate due to additional factors. The mean treatment duration was 12.6 months, and 47% had prior systemic therapy. Psychological assessments were documented in 58% of cases. After 36 weeks, 21 patients had not achieved a SALT score ≤ 20, yet 52% continued treatment for further review, and 38% continued long-term against national guidance. Most patients reported no adverse events. The study found regional prescribing largely aligned with national guidance but highlighted the need for improved psychological assessments and consistent SALT scoring to guide treatment continuation.