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
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    TLDR Ritlecitinib effectively regrows hair in severe alopecia areata, especially in adolescents.
    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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