Alopecia areata: ritlecitinib demonstrates sustained efficacy for up to 3 years

Durable efficacy of once-daily ritlecitinib 50 mg was observed in patients with alopecia areata (AA), with 89.6% of patients reaching a SALT (Severity of Alopecia Tool) score ≤20 after 1 year, and maintaining this benefit through month 36. Complete scalp hair regrowth was achieved in up to 31.2% patients at month 36.

Dr Brett King (Fairfield, CT, USA) presented data from 191 patients treated with ritlecitinib 50 mg once daily for 3 years in the ALLEGRO study programme (NCT03732807 and NCT04006457) [1].

Baseline characteristics comprised 14.1% of adolescents, 56% women, a mean baseline SALT score of 90.8, and a median duration of the current AA episode of 2.2 years.

At month 36, SALT≤20 and ≤10 were achieved by 47.1% and 36.7% in the last observation carried forward (LOCF) analysis, and by 65.1% and 52.3% in the as-observed analysis. Within the group of participants who achieved SALT≤20 at month 12, 89.6% (LOCF) maintained this response at month 36. Similarly, 84.8% (LOCF) maintained SALT≤10.

Complete regrowth of scalp hair was achieved in 31.2% (observed) and in 22.5% (LOCF) participants at month 36. Furthermore, 29.8% achieved a SALT score of 0 at ≥1 visit, and 61.5% of these participants maintained this response without subsequent worsening. Among participants whose SALT score relapsed, 5.2% had scores ≥20 at a later time point, but Dr King underlined that most of them remained at SALT ≤5.

Treatment responses in the Eyebrows (EBA) and Eyelashes (ELA) Assessment Tools were defined as ≥2-grade improvement or a normal score of 3 in patients with a prior abnormal score. EBA responses at 36 months were 63.2% (observed) and 48.7% (LOCF), while ELA responses were 60.4% (observed) and 49.6% (LOCF).

“In conclusion, ritlecitinib 50 mg once daily demonstrated clinically meaningful efficacy up to 3 years,” Dr King stated, further highlighting that almost 1 quarter of patients achieved complete scalp hair regrowth, as well as normal eyebrows and normal eyelashes at more than 1 timepoint in the clinical trial.

1. King B, et al. Long-term efficacy and complete scalp hair regrowth in patients with alopecia areata receiving ritlecitinib 50 mg QD up to 3 years in the ALLEGRO clinical trial program. D2T01.4A, EADV Congress 2025, 17–20 September, Paris, France.

Medical writing support was provided by Dr Susanne Kammerer and Karin Drooff

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Posted on 23 September 2025