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在斑秃患者中,无论有无早期目标反应,持续使用利特昔替尼治疗至48周可实现持续毛发生长:ALLEGRO 2b/3期试验的事后分析

Sustained hair regrowth with continued ritlecitinib treatment through week 48 in patients with alopecia areata with or without early target responses: Post hoc analysis of the ALLEGRO phase 2b/3 trial.

作者信息

Piliang Melissa, Lynde Charles, King Brett, Mirmirani Paradi, Sinclair Rodney, Senna Maryanne, Forman Seth, Bordone Lindsey, De La Cueva Dobao Pablo, Wolk Robert, Zwillich Samuel H, Tran Helen, Wajsbrot Dalia, Ahmed Haytham Mohamed, Takiya Liza

机构信息

Department of Dermatology, Cleveland Clinic, Cleveland, Ohio.

Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

出版信息

J Am Acad Dermatol. 2025 Feb;92(2):276-284. doi: 10.1016/j.jaad.2024.09.064. Epub 2024 Oct 17.

DOI:10.1016/j.jaad.2024.09.064
PMID:39423930
Abstract

BACKGROUND

Few treatments for alopecia areata have demonstrated sustained efficacy.

OBJECTIVE

Evaluate the efficacy and safety of continued ritlecitinib treatment to week 48 in patients with alopecia areata with or without target efficacy responses at week 24.

METHODS

Patients aged ≥12 years received daily ritlecitinib (±4-week loading dose): 200/50 mg, 200/30 mg, 50 mg, or 30 mg. Patients with clinical response at week 24, based on a Severity of Alopecia Tool (SALT) score ≤20 and ≤10, were evaluated for sustained response through week 48. Nonresponders at week 24 were assessed for response through week 48.

RESULTS

Among ritlecitinib-treated patients with SALT score ≤20 and ≤10 responses at week 24, ≥85% and ≥68%, respectively, sustained these responses through week 48. Of those with a SALT score >20 at week 24, 22% to 34% achieved a SALT score ≤20 at week 48. Of those with a SALT score >10 at week 24, 20% to 26% achieved a SALT score ≤10 at week 48. Safety was similar across subgroups.

LIMITATIONS

Small sample size.

CONCLUSION

Hair regrowth was sustained through week 48 in patients with response at week 24. Up to one-third of patients who did not meet target efficacy at week 24 achieved response with continued ritlecitinib treatment.

摘要

背景

斑秃的治疗方法中,很少有能证明具有持续疗效的。

目的

评估对于在第24周时有或没有达到目标疗效反应的斑秃患者,持续使用利特昔替尼治疗至第48周的疗效和安全性。

方法

年龄≥12岁的患者每日服用利特昔替尼(±4周负荷剂量):200/50毫克、200/30毫克、50毫克或30毫克。根据脱发严重程度工具(SALT)评分≤20和≤10,在第24周有临床反应的患者,评估其至第48周的持续反应情况。第24周无反应者评估其至第48周的反应情况。

结果

在第24周时SALT评分≤20和≤10的利特昔替尼治疗患者中,分别有≥85%和≥68%的患者至第48周维持了这些反应。在第24周时SALT评分>20的患者中,22%至34%在第48周时SALT评分≤20。在第24周时SALT评分>10的患者中,20%至26%在第48周时SALT评分≤10。各亚组的安全性相似。

局限性

样本量小。

结论

第24周有反应的患者至第48周毛发再生持续存在。在第24周未达到目标疗效的患者中,高达三分之一的患者通过持续使用利特昔替尼治疗获得了反应。

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引用本文的文献

1
Janus kinase inhibitors for alopecia areata: a review of clinical data.用于斑秃的Janus激酶抑制剂:临床数据综述
Front Immunol. 2025 May 13;16:1577115. doi: 10.3389/fimmu.2025.1577115. eCollection 2025.
2
Safety and Efficacy of Ritlecitinib for the Treatment of Patients with Alopecia Areata: A Systematic Review and Meta-Analysis of Controlled Trials.利特昔替尼治疗斑秃患者的安全性和有效性:一项对照试验的系统评价和荟萃分析
J Clin Med. 2025 Mar 8;14(6):1817. doi: 10.3390/jcm14061817.