Summary

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• This summary is based on the review of five systematic review(s)/meta-analysis(es). ^[1-5]
• Effectiveness of Ritlecitinib: Ritlecitinib 50 mg showed high efficacy in reducing the Severity of Alopecia Tool (SALT) score, achieving a strong relative effect (sucra = 0.8689 for SALT(50) response), indicating it is among the most effective Janus Kinase (JAK) inhibitors for alopecia areata (AA).
• Comparative Efficacy: Among JAK inhibitors, Ritlecitinib 200/50 mg demonstrated a dose-dependent effect and was highly effective, similar to brepocitinib 30 mg and baricitinib 4 mg, with these drugs showing the highest probabilities of being the most effective therapies for AA.
• Effectiveness in Severe Alopecia: Deuruxolitinib 12 mg was noted to be particularly effective for patients with severe AA, achieving a high success rate for the SALT(75) response (Surface Under the Cumulative RAnking curve (SUCRA) = 0.9761), although it may be associated with a higher likelihood of adverse events compared to other JAK inhibitors.
• Common Adverse Events (AES): Ritlecitinib was associated with acne (10.4%) and headache (12.5%), while deuruxolitinib reported higher rates of headache (21.4%) and acne (13.6%). Upper respiratory infections were comparable to placebo in baricitinib but increased with brepocitinib.
• Serious Adverse Events (SAES): Isolated grade 3-4 AEs were reported, including myocardial infarction, hypertensive urgencies, cellulitis, rhabdomyolysis, neutropenia, and significant elevation of creatinine kinase.
• The population types included patients with severe AA, where deuruxolitinib 12mg showed the highest efficacy. Oral JAK inhibitors demonstrated greater effectiveness compared to topical formulations across multiple studies, and patients discontinuing JAK inhibitors experienced high recurrence rates, suggesting the need for ongoing treatment to maintain results.