{ "abstract": "Background: Ritlecitinib, an oral Janus kinase (JAK) 3/tyrosine kinase expressed in hepatocellular carcinoma (TEC) family kinase inhibitor, demonstrated safety in patients aged 12 years and older with alopecia areata (AA) in an initial integrated analysis of 4 clinical studies for up to 2 years.\n\nObjective: This updated integrated safety analysis evaluated the safety of ritlecitinib up to ~ 5 years in patients aged ≥ 12 years with AA from the ALLEGRO clinical trial program.\n\nMethods: Safety data were pooled from 4 studies. Two groups were analyzed: patients who received any dose of ritlecitinib (30 mg or 50 mg with or without a 4-week 200 mg loading dose, or 10 mg daily) (“any-ritlecitinib” group) and a subset of the any-ritlecitinib group including only patients who received ritlecitinib 50 mg daily with or without a 4-week 200 mg daily loading dose (ritlecitinib 50 mg ± 200-mg group). Safety data were summarized descriptively. Proportions and incidence rates (IRs; IR/100 patient-years [PYs]) of adverse events (AEs) were evaluated.\n\nResults: In the ritlecitinib 50-mg ± 200-mg (N = 1228) and any-ritlecitinib (N = 1294) groups, median duration of exposure was 1197 days (3261.5 PYs) and 1204 days (3539.5 PYs), respectively. AEs occurred in 1070 patients (87.1%; 148.1/100 PYs) in the 50-mg ± 200-mg group and 1158 patients (89.5%; 167.9/100 PYs) in the any-ritlecitinib group. The most common AEs included headache, positive SARS-CoV-2 test, and nasopharyngitis. Serious AEs were reported in 6.8% of patients (2.6/100 PYs) in the 50-mg ± 200-mg group and 6.8% of patients (2.5/100 PYs) in the any-ritlecitinib group. There were two deaths. Overall, 8.1% of patients (3.0/100 PYs) and 8.4% of patients (3.0/100 PYs) in the 50-mg ± 200-mg and any-ritlecitinib groups, respectively, had an AE that led to discontinuation from the study or study drug. IRs for both groups were 0.1/100 PYs for opportunistic infections, 1.0/100 PYs for herpes zoster, 0.3/100 PYs for malignancies (excluding nonmelanoma skin cancer), and 0.2/100 PYs for major adverse cardiovascular events.\n\nConclusions: In this updated integrated safety analysis of the ALLEGRO clinical trials, long-term ritlecitinib treatment was generally well tolerated up to ~ 5 years in patients aged ≥ 12 years with AA. The overall safety profile was consistent with previously reported data.\n\nClinical Trial Registration: NCT03732807, NCT04006457, NCT04517864, NCT02974868.\n\nGraphical Abstract:\n\nVideo Abstract: Video AbstractUpdated integrated safety analysis of ritlecitinib up to ~ 5 years in patients with alopecia areata from the ALLEGRO clinical trial program (MP4 407314 KB)\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s40257-026-01062-x.", "abstract_shown": true, "affiliations": [ "Lahey Hospital and Medical Center, Burlington, MA USA", "University of Toronto, Toronto, ON Canada", "Juntendo University, Tokyo, Japan", "The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China", "Department of Dermatology, Johns Hopkins Medicine, Baltimore, MD USA", "Piraccini Medical Center, Bologna, Italy", "Pfizer Inc, Groton, CT USA", "Pfizer Inc UK, Sandwich, Kent UK", "Pfizer Inc, New York, NY USA", "Pfizer Inc, 23 Av. du Dr Lannelongue, 75014 Paris, France" ], "article_type": "research article", "arxiv": null, "author_total": 13, "authors": [ { "affs": [ 0 ], "name": "Maryanne Senna" }, { "affs": [ 1 ], "name": "Sameh Hanna" }, { "affs": [ 2 ], "name": "Rie Ueki" }, { "affs": [ 3 ], "name": "Xingqi Zhang" }, { "affs": [ 4 ], "name": "Crystal Aguh" }, { "affs": [ 5 ], "name": "Bianca Maria Piraccini" }, { "affs": [ 6 ], "name": "Dalia Wajsbrot" }, { "affs": [ 7 ], "name": "Edward Nagy" }, { "affs": [ 8 ], "name": "Mojgan Sadrarhami" }, { "affs": [ 8 ], "name": "Simon Chen" }, { "affs": [ 6 ], "name": "Robert Wolk" }, { "affs": [ 8 ], "name": "Helen Tran" }, { "affs": [ 9 ], "name": "Alexandre Lejeune" } ], "bibtex": "https://research.draconitic.com/paper/7cb6039cmzcc1.bib", "cited_by": 2, "doi": "10.1007/s40257-026-01062-x", "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13717632/", "id": "7cb6039cmzcc1", "issns": [ "1175-0561", "1179-1888" ], "landing_url": "https://doi.org/10.1007/s40257-026-01062-x", "language": "en", "licence": "CC-BY-NC-4.0", "licence_label": "CC BY-NC 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Original Research Article" ], [ "openalex", "2748|Hair Growth and Disorders" ] ], "openalex": "W4416084993", "pdf_url": "https://link.springer.com/content/pdf/10.1007/s40257-026-01062-x.pdf", "pmcid": "PMC13717632", "pmid": "42481842", "published": "2026-07-22", "publisher": null, "ris": "https://research.draconitic.com/paper/7cb6039cmzcc1.ris", "sources": [ { "first_seen": "2026-11-02T12:21:55Z", "native_id": "PMC13717632", "source": "pmc", "url": "https://doi.org/10.1007/s40257-026-01062-x" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2748|Hair Growth and Disorders", "subfield": "general" } ], "title": "Updated Integrated Safety Analysis of Ritlecitinib up to ~ 5 Years in Patients with Alopecia Areata from the ALLEGRO Clinical Trial Program", "title_text": "Updated Integrated Safety Analysis of Ritlecitinib up to ~ 5 Years in Patients with Alopecia Areata from the ALLEGRO Clinical Trial Program", "type": "peer-reviewed", "updated_at": "2026-11-02T12:21:55Z", "url": "https://research.draconitic.com/paper/7cb6039cmzcc1", "venue": "American Journal of Clinical Dermatology", "versions": [] }