Photo Credit: Alona Siniehina

Results from the ALLEGRO trial show considerable regrowth of hair in patients with alopecia totalis and alopecia universalis.

In an analysis of the ALLEGRO trial, ritlecitinib therapy for up to 24 months led to considerable hair regrowth in patients with alopecia totalis (AT) and alopecia universalis (AU). For the best possible results, patients with alopecia areata (AA) should be treated as early as possible.

Both AT and AU are difficult-to-treat subtypes of AA. In a subset analysis, Melissa Piliang, MD, and colleagues assessed the efficacy of ritlecitinib treatment up to month 24 for patients with AT/AU who participated in the ALLEGRO phase 2/b study (NCT03732807) and the ongoing, long-term phase 3 ALLEGRO-LT (NCT04006457) study.¹

In the previous ALLEGRO trial, the JAK3/TEC kinase inhibitor ritlecitinib demonstrated efficacy and acceptable safety in participants with AA who were aged 12 years and older. At week 24, 31% of participants treated with the highest ritlecitinib dose achieved a Severity of Alopecia Tool (SALT) score of 20 or less.² In the new analysis, researchers evaluated SALT on an observed or last-observation-carried-forward (LOCF) basis.¹ The study team defined AT/AU as patients with a SALT score of 100 at baseline.

At month 24, 59.6% of participants with AT/AU at baseline achieved a SALT less than or equal to 20 in the observed analysis (36.1% in the LOCF analysis). Thus, sustained responses in the subgroup of participants with AT/AU were similar to those in the overall trial. Both in the AT/AU and the non-AT/AU populations, responses increased over time and were maintained for as long as participants remained on therapy.

Dr. Piliang emphasized that a SALT less than or equal to 10 means that patients have 90% hair regrowth. Of the AT/AU population, 53.2% achieved a SALT score in this range in the as-observed analysis (31.4% in the LOCF analysis). “A substantial proportion of patients with AT/AU are achieving 90% or more of hair regrowth, so really an excellent response,” Dr. Piliang concluded.

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