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The updated integrated safety analysis of the ALLEGRO clinical trials evaluated the long-term safety of ritlecitinib in patients aged 12 years and older with alopecia areata over approximately 5 years. The study included 1,294 patients in the any-ritlecitinib group and 1,228 in the ritlecitinib 50 mg ± 200 mg group. Adverse events (AEs) were common, occurring in 87.1% of the 50 mg ± 200 mg group and 89.5% of the any-ritlecitinib group, with headache, positive SARS-CoV-2 test, and nasopharyngitis being the most frequent. Serious AEs were reported in 6.8% of patients in both groups. The incidence rates for opportunistic infections, herpes zoster, malignancies, and major adverse cardiovascular events were low. Overall, the safety profile of ritlecitinib was consistent with previous data, indicating it was generally well tolerated for long-term use in this patient population.

This study evaluated the real-world use of ritlecitinib for treating severe alopecia areata (AA) in 145 patients at a UK dermatology center. Of the 19 patients who completed 36 weeks of treatment, 37% achieved significant hair regrowth with SALT scores ≤ 20, while 32% had moderate improvement, and 32% were nonresponders. Notably, 83% of nonresponders had AA for over 10 years, suggesting that the duration of AA may affect treatment response. No serious adverse effects were reported, and only 4.1% discontinued treatment due to minor side effects or unrelated reasons. The findings indicate that ritlecitinib is effective and safe, though further long-term data are needed.

This multicentre retrospective study evaluated the real-world efficacy and safety of ritlecitinib in treating alopecia areata (AA) in 31 patients, with an average age of 36 years and a female-to-male ratio of 4:1. After 52 weeks of treatment, 51% of patients achieved a Severity of Alopecia Tool (SALT) score of ≤ 20, indicating significant hair regrowth, although the response was slow, with only 8 patients showing benefits by week 16. The study found no serious adverse events, though 2 patients experienced treatment interruptions due to transient blood abnormalities or infection. These findings suggest that ritlecitinib is a promising treatment for AA, with international registries needed to further explore predictors of response and treatment duration.

This study analyzed the real-world use of ritlecitinib, an oral treatment for severe alopecia areata (AA), in 123 adults in the USA. The average patient age was 37 years, with a mean disease duration of 2.1 years. Nearly half of the patients were using ritlecitinib as their first AA treatment. Results showed that hair regrowth and treatment satisfaction increased with longer treatment duration: 49% of patients experienced hair regrowth within 3 months, rising to 82% after more than 6 months. Satisfaction with AA control also improved from 54% to 85% over the same period. Many patients initially felt embarrassed, frustrated, and anxious due to their condition. Ritlecitinib was chosen for its efficacy, safety, and cost-effectiveness, and it was found to improve hair growth and quality of life, particularly with sustained use.