Sustained hair regrowth with continued ritlecitinib treatment through week 48 in patients with alopecia areata with or without early target responses: Post hoc analysis of the ALLEGRO phase 2b/3 trial.

Piliang, Melissa; Lynde, Charles; King, Brett; Mirmirani, Paradi; Sinclair, Rodney; Senna, Maryanne; Forman, Seth; Bordone, Lindsey et al. · J Am Acad Dermatol · 2025

case_series · Level IV

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Abstract

Few treatments for alopecia areata have demonstrated sustained efficacy. Evaluate the efficacy and safety of continued ritlecitinib treatment to week 48 in patients with alopecia areata with or without target efficacy responses at week 24. Patients aged ≥12 years received daily ritlecitinib (±4-week loading dose): 200/50 mg, 200/30 mg, 50 mg, or 30 mg. Patients with clinical response at week 24, based on a Severity of Alopecia Tool (SALT) score ≤20 and ≤10, were evaluated for sustained response through week 48. Nonresponders at week 24 were assessed for response through week 48. Among ritlecitinib-treated patients with SALT score ≤20 and ≤10 responses at week 24, ≥85% and ≥68%, respectively, sustained these responses through week 48. Of those with a SALT score >20 at week 24, 22% to 34% achieved a SALT score ≤20 at week 48. Of those with a SALT score >10 at week 24, 20% to 26% achieved a SALT score ≤10 at week 48. Safety was similar across subgroups. Small sample size. Hair regrowth was sustained through week 48 in patients with response at week 24. Up to one-third of patients who did not meet target efficacy at week 24 achieved response with continued ritlecitinib treatment.

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