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Clinical Trial
. 2025 Feb;92(2):276-284.
doi: 10.1016/j.jaad.2024.09.064. Epub 2024 Oct 17.

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

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Free article
Clinical Trial

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

Melissa Piliang et al. J Am Acad Dermatol. 2025 Feb.
Free article

Abstract

Background: Few treatments for alopecia areata have demonstrated sustained efficacy.

Objective: 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.

Methods: 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.

Results: 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.

Limitations: Small sample size.

Conclusion: 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.

Keywords: JAK3/TEC family kinase inhibitor; alopecia; alopecia areata; clinical research; drug response; hair research; ritlecitinib; sustained response.

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Conflict of interest statement

Conflicts of interest Dr Piliang is a consultant and/or an investigator for Pfizer, Eli Lilly, and Proctor & Gamble. Dr Lynde is aspeaker and/or a consultant for AbbVie, Altius, Amgen, Aralez, Arcutis, Bausch Health, Bayer, Boehringer Ingelheim, BMS, Celgene, Cipher, Dermavant, Eli Lilly, Fresnius Kabi, GSK, Innovaderm, Intega Skin, Janssen, Kyowa, La Roche Posay, LEO Pharma, L’Oréal, Medexus, Merck, Proctor & Gamble, Pediapharm, Regeneron, Roche, Sanofi Genzyme, Sentrex, TEVA, Tribute, UCB, Valeant, and Viatris; and is a principal investigator for AbbVie, Amgen, Aralez, Arcutis, Bausch Health, Bayer, Boehringer Ingelheim, BMS, Celgene, Cipher, Dermavant, Eli Lilly, GSK, Innovaderm, Janssen, Kyowa, LEO Pharma, L’Oréal, Merck, Pediapharm, Regeneron, Roche, Sanofi Genzyme, Tribute, UCB, and Valeant. Dr King has served on advisory boards and/or is a consultant and/or a clinical trial investigator and/or on a data monitoring committee for AbbVie, AltruBio Inc, Almirall, AnaptysBio, Arena Pharmaceuticals, Aslan Pharmaceuticals, Bioniz Therapeutics, Bristol Myers Squibb, Concert Pharmaceuticals Inc, Equillium, Horizon Therapeutics, Eli Lilly and Company, Incyte Corp, Janssen Pharmaceuticals, LEO Pharma, Merck, Otsuka/Visterra Inc, Pfizer Inc, Q32 Bio Inc, Regeneron, Sanofi Genzyme, SUN Pharmaceutical, TWi Biotechnology Inc, Viela Bio, and Ventyx Biosciences Inc; is on speakers bureaus for AbbVie, Incyte, Eli Lilly, Pfizer, Regeneron, and Sanofi Genzyme; and is a scientific advisor for BiologicsMD. Dr Mirmirani has received investigator grants and/or research funding from Concert Pharmaceuticals, Pfizer, and Eli Lilly. Dr Sinclair has provided professional services for AbbVie, Aerotech, Amgen, Arena, Arcutis, Aksebio, AstraZeneca, Ascend, Bayer, Boehringer Ingelheim, BMS, Celgene, Coherus Biosciences, Cutanea, Connect, Demira, Eli Lilly, Galderma, GSK, Janssen, LEO Pharma, MedImmune, Merck, MSD, Novartis, Oncobiologics, Pfizer, Regeneron, Reistone, Roche, Sanofi, Samson Clinical, SUN Pharma, and UCB. Dr Senna has served on scientific advisory board for Eli Lilly, Arena Pharmaceuticals, Pfizer, and L’Oréal; is a consultant for Kintor, Eli Lilly, and Pfizer; is a speaker for Eli Lilly and Pfizer; has received research funding from Eli Lilly, Concert, Clarity, Follica, LEO Pharma, and Santiste; is on the board of directors for the Scarring Alopecia Foundation and American Hair Research Society. Dr Cueva has participated as a consultant and advisory board member for and received honoraria for speaking and/or clinical trials with the following pharmaceutical companies: AbbVie, Almirall, Amgen, Astellas, Biogen, Boehringer Ingelheim, Celgene, Janssen., LEO Pharma, Eli Lilly, MSD, Novartis, Pfizer, Roche, Sanofi, and UCB. Drs Wolk, Zwillich, Tran, Wajsbrot, Ahmed, and Takiya are employees of and hold stock or stock options in Pfizer. Drs Forman and Bordone have no conflicts of interest to declare.

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