利特昔替尼(Ritlecitinib)治疗脂溢性脱发吗？

Ritlecitinib is a drug used to treat severe alopecia areata. It is not clinically suitable for the treatment of seborrheic alopecia. Patients with seborrheic alopecia can choose other appropriate drug treatments under the guidance of a doctor.

Indications for Ritlecitinib

It is an oral kinase inhibitor developed by Pfizer for the treatment of alopecia areata, ulcerative colitis, vitiligo and Crohn's disease. On June 23, 2023, Ritlecitinib was approved in the United States for the treatment of severe alopecia areata in adults and adolescents 12 years and older. Ritlecitinib was approved in Japan on June 26, 2023, for the treatment of alopecia areata (limited to refractory cases involving widespread hair loss).

Ritlecitinib does not treat seborrheic alopecia

Ritlecitinib is a kinase inhibitor that is mainly used clinically to treat alopecia areata. There are currently no studies proving that Ritlecitinib can be used to treat seborrheic alopecia.

Efficacy of Ritlecitinib in the treatment of alopecia areata

Background: Alopecia areata is characterized by non-scarring loss of scalp, facial or body hair. A trial investigated the efficacy and safety of the oral selective dual JAK3/TEC family kinase inhibitor Ritlecitinib in patients with alopecia areata.

Methods: Patients aged 12 years and older with alopecia areata and at least 50% scalp hair loss were randomly assigned to Ritlecitinib or placebo once daily for 24 weeks, with or without a 4-week loading dose (50 mg, 30 mg, 10 mg, 200 mg loading dose followed by 50 mg, or 200 mg loading dose followed by 30 mg). This was followed by a 24-week extension period, during which the Ritlecitinib arm continued its assigned dose and patients initially assigned to the placebo arm switched to a loading dose of Ritlecitinib 50 mg or 200 mg, then 50 mg. The primary endpoint was a Severe Hair Loss Tool (SALT) score of 20 or less at week 24.

Results: Between December 3, 2018 and June 24, 2021, 1097 patients were screened, 718 of whom were randomly assigned to receive 200mg+50mg, 200mg +30 mg, 50 mg, 30 mg, 10 mg, 50 mg placebo, or 200 mg + 50 mg placebo. Of the 718 patients, 446 (62%) were female and 272 (38%) were male.

Of the 718 patients randomly assigned, 104 patients discontinued treatment. At week 24, 38 of 124 (31%) patients in the 200 mg + 50 mg Ritlecitinib group, 27 of 121 (22%) patients in the 200 mg + 30 mg group, and 50 of 121 patients in the 200 mg + 30 mg group Responses based on a SALT score of 20 or less occurred in 29 of 124 (23%) patients in the mg group, 17 of 119 (14%) patients in the 30 mg group, and 2 of 130 (2%) patients in the placebo group. The difference between the placebo group and the Ritlecitinib 200 mg + 50 mg group based on a SALT score of 20 or less was 29 ± 1%.

It can be seen that Ritlecitinib is effective and well tolerated in patients with alopecia areata aged 12 years and above.

Treatment and precautions for seborrheic alopecia

1. Treatment: Seborrheic alopecia is generally related to genetics, androgen and other factors. Mental stress, high pressure, living and eating habits, etc. may aggravate hair loss. Patients can use finasteride, cyproterone, minoxidil, spironolactone and other drugs under the guidance of a doctor.

In addition, surgical treatment can also be performed to extract and process hair follicles from non-hair loss areas (such as occiput, beard, armpits, etc.), and then transplant them to hair loss or bald areas to achieve a beautiful appearance.

2. Precautions: Patients are advised to develop good hygiene habits, keep their heads clean, avoid using harsh chemicals, such as products containing strong fragrances, alcohol or sulfur, and choose cleansing products with mild formulas. When combing your hair, you should be gentle and apply even force to avoid pulling. Eat a light diet and avoid spicy and greasy foods, such as chili peppers, fried chicken, barbecue, etc., to avoid irritating the skin and aggravating the condition.

Summary

Ritlecitinib has obvious efficacy in treating alopecia areata, but there is currently no evidence that it can be used to treat seborrheic alopecia. Patients with seborrheic alopecia can undergo systemic treatment under the guidance of a doctor. At the same time, paying attention to protecting their hair and maintaining good living habits in daily life can help delay the degree of hair loss.

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