Improvement in Patient‐Reported Emotional Symptoms and Activity Limitations due to Hair Loss in Patients With Alopecia Areata Treated With Ritlecitinib: Additional Analyses From ALLEGRO‐2b/3

Background Patients with alopecia areata (AA) in ALLEGRO‐2b/3 (NCT03732807) had clinically significant hair regrowth and patient‐reported improvements with ritlecitinib versus placebo, but patient‐reported improvements in AA Patient Priority Outcomes (AAPPO) emotional symptoms (ES) or activity limitations (AL) were not observed during the 24‐week placebo‐controlled phase. This study compared AAPPO scores between the 50‐mg ritlecitinib maintenance dose (+/− 200‐mg 4‐week loading dose) and subtherapeutic 10‐mg ritlecitinib through Week 48 of ALLEGRO‐2b/3. Methods Least squares mean (LSM) changes from baseline (CFBs) in domain scores were estimated for the full analysis population and for participants with baseline domain scores ≥ 1. Item‐level responses (scores < 2) were evaluated for participants with baseline item scores ≥ 2, since lower baseline item scores (measured on 5‐point response scales; range, 0–4) indicated less frequent/severe impacts from hair loss. Results There were 325 participants (200/50‐mg [ n = 132] and 50‐mg [ n = 130], combined and as subgroups; 10‐mg [ n = 63]). LSM CFBs in ES and AL domain scores generally improved through Week 48 for all 50‐mg groups, with significant differences versus 10‐mg starting at Week 34 for ES and Week 40 for AL. The proportion of responders for all ES and AL items generally increased through Week 48 for all 50‐mg groups. The largest improvements versus 10‐mg were for ES items 5 and 6 (self‐consciousness and embarrassment) and AL item 11 (interactions with others). Conclusions ALLEGRO‐2b/3 participants reported greater improvements in ES and AL due to hair loss by Week 48 with the 50‐mg ritlecitinib maintenance dose (+/− 200‐mg loading dose) versus subtherapeutic 10‐mg ritlecitinib.