Dynamics of Lipid Profile in Patients With Alopecia Areata Treated With Ritlecitinib: A Descriptive, Retrospective, Real-World Study

Background: Despite the established therapeutic potential of ritlecitinib for alopecia areata (AA), real-world evidence regarding its effects on lipid metabolism remains limited. Objective: To characterize the effects of ritlecitinib therapy on lipid profiles in patients with AA. Methods: In this single-center retrospective cohort study, we evaluated 55 patients with AA who completed ≥24 weeks of ritlecitinib therapy. Fasting serum lipid parameters (total cholesterol, triglycerides, high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol, non-HDL-C), and atherogenic index of plasma (AIP) were assessed at baseline, 12, and 24 weeks. Comparative analyses were conducted between patients with normal versus abnormal baseline lipid profiles. Results: Ritlecitinib therapy demonstrated stability across conventional lipid parameters throughout the 24 week observation period. A clinically significant reduction in AIP was observed at 12 weeks (median change: −0.31, 95% CI: −0.37 to −0.21; P < .05). Patients with baseline dyslipidemia exhibited progressive improvement in atherogenic lipid fractions, suggesting a potential therapeutic modulation of lipid metabolism. Limitations: Single-center and Chinese-limited cohort. Conclusion: These real-world data suggest ritlecitinib maintains a favorable lipid safety profile while potentially conferring metabolic benefits for AA patients with preexisting dyslipidemia.