Alopecia areata (AA) is an autoimmune form of hair loss with limited treatments.To evaluate the efficacy and safety of the Janus kinase inhibitors ritlecitinib and brepocitinib in patients with AA with ≥50% scalp hair loss.Patients were randomized to once-daily ritlecitinib, brepocitinib, or placebo. The primary efficacy endpoint was 24-week change from baseline in Severity of Alopecia Tool (SALT) score; the key secondary efficacy endpoint was proportion of patients achieving 30% improvement in SALT score (SALT30).The ritlecitinib, brepocitinib, and placebo groups included 48, 47, and 47 patients, respectively. At week 24, least-squares mean difference from placebo in SALT score change from baseline was 31.1 (95% CI, 18.8-43.5) for ritlecitinib and 49.2 (95% CI, 36.6-61.7) for brepocitinib (P < .0001 for both comparisons with placebo). SALT30 was achieved by 50% (90% CI 38-62%) of patients receiving ritlecitinib, 64% (90% CI, 51-75%) receiving brepocitinib, and 2% (90% CI, 0-9%) receiving placebo. Two patients experienced a serious adverse event (rhabdomyolysis) in the brepocitinib group only.Only a single dosage regimen of each study drug was included.Treatment with ritlecitinib or brepocitinib for 24 weeks was efficacious and generally well tolerated.
Brett King, Emma Guttman-Yassky, Elena Peeva, Anindita Banerjee, Rodney Sinclair, Ana B Pavel, Linda Zhu, Lori Ann Cox, Brittany Craiglow, Linda Chen, Christopher Banfield, Karen Page, Weidong Zhang, Michael S Vincent