Ritlecitinib, an oral, selective dual inhibitor of Janus kinase (JAK) 3 and tyrosine kinase expressed in hepatocellular carcinoma (TEC) family kinases, is approved for treating severe alopecia areata (AA) in patients aged ≥ 12 years in the USA. This study describes characteristics, treatment satisfaction, and success among adults initiating ritlecitinib. A sample of US dermatologists treating adults who received ritlecitinib for severe AA were surveyed between November 2023 and June 2024. Demographics, clinical characteristics, treatment history, satisfaction, and health-related quality of life were analyzed overall, among recent initiators, and stratified by treatment duration. A total of 123 adults were included (mean age 37.1 years; 57% male; 79% white; 88% commercial insurance). Mean disease duration was 2.1 years. At ritlecitinib initiation (n = 93), mean scalp hair loss was 71% and 73% had worsening AA. The proportion of patients with hair regrowth increased with longer treatment duration, 49% among those with 6 months (n = 28/34). Physicians reported many recent initiators (n = 26) felt moderate/severe embarrassment (84%), frustration (73%), and anxiety (65%) due to their AA. Among patients with available data (n = 102), ritlecitinib was the first AA treatment for 46%. Treatment goals (n = 123) included reducing hair loss (94%), improving quality-of-life (41%), and achieving long-term control (32%). Reasons for selecting ritlecitinib (n = 113) included its ability to reduce scalp hair loss (38%), cost–benefit ratio (28%), and safety profile (25%). Satisfaction with AA control was 54%, 68%, and 85% after 6 months (n = 29/34), respectively, of ritlecitinib treatment. Many patients experienced psychological burden due to their AA around the start of treatment. Ritlecitinib was chosen for its efficacy, safety, and cost-effectiveness. Hair regrowth, disease stability, and treatment satisfaction increased with longer ritlecitinib treatment duration suggesting sustained treatment is important for achieving treatment goals. Alopecia areata (AA) is an autoimmune condition that causes patchy or total hair loss on the scalp and can also include loss of body hair. People with severe AA often experience distress, embarrassment, and reduced quality of life. Ritlecitinib is an oral treatment that is approved for treating severe AA in adults and adolescents (people aged 12 years and older). This study, using data from the Adelphi Real World AA II US Disease Specific Programme™, surveyed US dermatologists treating adult severe AA patients with ritlecitinib between November 2023 and June 2024. The study collected information on patient characteristics, reasons for choosing ritlecitinib, emotional impact, and satisfaction with treatment. A total of 123 adults were included. The average patient age was 37 years, and most had experienced AA for about 2 years. Nearly half were receiving ritlecitinib as their first AA treatment. Hair regrowth, disease stability, and satisfaction increased with longer ritlecitinib use. Hair regrowth was seen in 49% of patients who had been treated up to 3 months and 82% treated more than 6 months. Satisfaction with AA control rose from 54% to 85% across the same period. In a subset of patients who recently started ritlecitinib treatment, many felt embarrassed (84%), frustrated (73%), and anxious (65%) about their condition before receiving ritlecitinib. Overall, doctors selected ritlecitinib for its effectiveness, safety, and cost-effectiveness. These real-world results show that ritlecitinib can improve hair growth and quality of life for people with severe AA, especially when treatment is maintained over time.
Kurosky et al. (Sat,) studied this question.