Individual SALT score trajectories of de novo patients with alopecia areata (AA) treated with ritlecitinib in the ongoing phase 3, long-term, open-label ALLEGRO-LT study

This post-hoc analysis of the ongoing phase 3 ALLEGRO-LT study (NCT04006457) evaluated Severity of Alopecia Tool (SALT) score trajectories in ritlecitinib-treated patients with AA. Analysis included ritlecitinib-treated de novo patients enrolled in ALLEGRO-LT who had not received treatment in other ALLEGRO studies (N=447). Patients aged ≥12 years with AA and ≥25% scalp hair loss received ritlecitinib 200 mg once-daily (QD) for 4 weeks (loading dose), followed by 50 mg QD. SALT score trajectories were assessed up to Week (W) 96. Patients were categorized as responders, partial responders, non-responders, or relapsers, based on three periods (early [Baseline-W24], middle [W24-W48], and late [W48-W96]), achieving SALT score ≤20 response (responders), or 30% SALT score improvement from baseline (partial responders). Multivariable logistic regression was used to assess the impact of demographics and disease characteristics on response. SALT score trajectories showed that 275 (61.5%) patients were responders (early: n=98 [44.3%]; middle: n=51 [11.4%]; late: n=26 [5.8%]), 53 (11.9%) partial responders, 98 (21.9%) non-responders, and 21 (4.7%) relapsers. Sex (female), SALT score <100, and shorter episode/disease duration were associated with treatment response. Over 60% of ritlecitinib-treated patients were SALT score responders, most of whom had an early response. Analysis of individual response profiles may help identify patient and disease characteristics associated with treatment response.