The FDA in America have approved Ritlecitinib for the treatment of severe alopecia areata (AA). This is an addition to Baricitinib which was approved a year ago by the FDA for the same condition (severe AA). These drugs act as JAK inhibitors (Janus kinase). The FDA approved dose for Ritlecitinib is 50mg once a day to treat severe alopecia areata for patients above the age of 12 years.
In February 2024, MHRA (Medicines and Healthcare products Regulatory Agency) in UK have also approved Ritlecitinib for the treatment of severe alopecia areata. The list price for treatment is £949 per month.
In trials, serious adverse events occurred in 2% of patients. Side effects included infections (herpes zoster, upper respiratory infections), headaches, acne, possible increase risk in skin cancer. It can have interactions with other medications so dose adjustments may be required for affected medicines.
Certain group of individuals cannot be prescribed Ritlecitinib. This list includes (not exhaustive – seek medical advice): Previous history of cancer, high risk of cancer, history and risk of DVT, current or past smoking history, cardiovascular disease, active or chronic infections, history of untreated TB. `the other usual contraindications include pregnancy, breast feeding, renal and liver impairment, allergies to similar class of drugs.
It is important to note that not all patients on JAK inhibitors maintain excellent hair growth in the long term. There seems to be some drop in hair growth over time when compared to initial first 1-2 years