Real-world efficacy of ritlecitinib in treating alopecia areata across various anatomical sites: Potential rapid response predictors.

Background: Effectiveness of ritlecitinib for alopecia areata (AA) is unknown in real-world practice.

Objective: This real-world study aimed to evaluate the effectiveness and safety of ritlecitinib in a heterogeneous cohort of AA patients and identify response in scalp as well as lashes, brows and nails, and clinical predictors of early treatment response.

Methods: We conducted a single-center retrospective cohort study of consecutive patients receiving ritlecitinib 50 mg daily for ≥12 weeks. Disease severity was assessed at baseline and weeks 4, 8, 12, 24, and 36. Treatment-emergent adverse events (AEs) were systematically recorded. Multivariate logistic regression models assessed the link between treatment response and clinical predictors.

Results: The cohort comprised 89 patients (mean age 25.6 ± 13.9 years; 69.7% female). Efficacy outcomes demonstrated temporal progression. The therapeutic efficacy observed in eyelashes, eyebrows, and nails paralleled that of the scalp. Multivariate analysis identified prior JAK inhibitor exposure as an independent predictor of reduced early response. Ritlecitinib demonstrated a favorable safety profile, with no serious AEs reported throughout the study period.

Limitations: Single-center and Chinese-limited cohort.

Conclusion: Prior JAK inhibitor exposure as a significant factor influencing early treatment response. Responses of lashes, brows and nails were similar to scalp.