In June 2023, the US Food and Drug Administration (FDA) approved ritlecitinib (50 mg once daily) for treatment of severe alopecia areata (AA) in patients ≥ 12 years. This study aimed to assess the characteristics of patients prescribed ritlecitinib within the first 10 months following approval. This retrospective study analyzed data from the Komodo Healthcare Map® (Komodo) and OMNY Health Foundation databases. Patients were aged ≥ 12 years with ≥ 1 ritlecitinib prescription on or after June 23, 2023, ≥ 1 AA diagnoses on or before index date (first prescription date), and ≥ 12 months of continuous enrollment before study entry. Two cohorts were assessed: patients with Komodo data (cohort 1) and linked Komodo and OMNY data (cohort 2). Clinical characteristics and AA treatment history were assessed over the 12-month pre-index period and stratified by age (12–17 and ≥ 18 years). Cohort 1 included 2562 patients; of these, 61.8% were prescribed ritlecitinib by a dermatologist, 58.9% were female, and 35.2% were adolescents. Approximately 24% had alopecia totalis/alopecia universalis as the closest diagnosis prior to index, 12.4% had ≥ 1 other autoimmune disorder, 23.9% had ≥ 1 atopic disorder, and 23.7% had ≥ 1 diagnosis of a mental health condition captured. In cohort 1 during the 12 months before index date, 26.6% of patients received no AA treatments, 31.9% received systemic immunomodulators, and 31.3% received injectable corticosteroids. Cohort 2 included 381 patients; of those in cohort 2 with reported disease location, hair loss primarily occurred on the scalp (90.5%) and face (43.2%). In cohort 2, 77.2% of patients with a scalp hair loss (SHL) assessment had ≥ 50% SHL. In the first 10 months following US approval, ritlecitinib was prescribed to a broad range of patients, including those with and without prior treatments and comorbidities. This suggests that ritlecitinib may provide new opportunities to engage or re-engage patients in AA-directed care. Ritlecitinib is an oral medicine used to treat severe alopecia areata (AA) in adults and adolescents ≥12 years of age. Ritlecitinib was approved by the US Food and Drug Administration in June 2023, and studies have shown ritlecitinib to be safe and effective. However, less is known about how ritlecitinib is used in everyday clinical practice. This study describes the characteristics of patients with AA (aged ≥12 years) who were prescribed ritlecitinib during the first 10 months after approval. Most patients (62%) were prescribed ritlecitinib by a dermatologist, 59% were female, and 35% were adolescents (12–17 years old). About one in four patients (24%) had severe forms of AA, identified by a recorded diagnosis of either alopecia totalis (complete scalp hair loss) or alopecia universalis (complete scalp and body hair loss), around the time of their first ritlecitinib prescription. Twelve percent of patients had at least one other autoimmune condition, 24% had at least one allergy-related condition, and 24% had at least one diagnosed mental health condition. In the year before the first ritlecitinib prescription, 27% of patients received no AA treatments, while about one-third received immune-system-targeting medications (32%) and/or steroid injections (31%). In the subset of patients with linked electronic health records and scalp hair loss measurements, about three-quarters (77%) had hair loss on ≥50% of their scalp. Overall, during the first 10 months after approval, ritlecitinib was prescribed to patients with a wide range of treatment histories and health conditions, supporting its role as a treatment option for AA.
Ko et al. (Sat,) studied this question.