Assessing Risk and Safety of JAK Inhibitors

Author(s):

Arash Mostaghimi, MD, MPH,Amy McMichael, MD

Key Takeaways

Ritlecitinib achieved modest SALT score improvements at 24 weeks, with 23% reaching SALT≤20 and 13.4% reaching SALT≤10 on 50 mg QD.
Deuruxolitinib showed significant SALT score improvements, with 56.8% achieving SALT≤20 at 12 mg BID, especially in partial hair loss cases.
Ritlecitinib had a higher incidence of TEAEs (75%) compared to deuruxolitinib (34.9% at 12 mg BID), with common AEs including infections and headaches.
Deuruxolitinib's common TEAEs included headache, acne, and increased blood creatinine phosphokinase, with no heart-related adverse events reported.

Panelists discuss the efficacy and safety data for ritlecitinib and deuruxolitinib in treating alopecia areata, highlighting that ritlecitinib achieved SALT scores of ≤20 in 23% of patients at week 24 compared to 1.6% in the placebo group, while deuruxolitinib showed SALT scores of ≤20 in 42.5% (8mg BID ) and 56.8% (12mg BID) of patients, with treatment-emergent adverse events primarily being mild to moderate, including upper respiratory tract infections and headaches for ritlecitinib, and headache and acne for deuruxolitinib.

EP: 1.Impact of Alopecia Areata on Quality of Life, and Current Standard of Treatment

EP: 2.JAK Inhibitor Baricitinib for Treatment of Alopecia Areata

EP: 3.Analyzing Phase 3 Clinical Trial Data of Baricitinib in Alopecia Areata

EP: 4.Novel Mechanisms of Action for Treatment of Alopecia Areata

EP: 5.Physician and Patient Communication for the Management of Alopecia Areata

EP: 6.The Pathophysiology of Alopecia Areata

EP: 7.The Benefits of Early Diagnosis of Alopecia Areata

EP: 8.Patient Factors and Other Considerations for Treatment Selection

EP: 9.Treatment Options for Alopecia Areata

EP: 10.Review of FDA Approved JAK Inhibitors for Alopecia Areata

EP: 11.JAK Inhibition in the Treatment of Alopecia Areata

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EP: 12.Assessing Risk and Safety of JAK Inhibitors

EP: 13.Real-World Clinical Experience With JAK Inhibitors

Video content above is prompted by the following:

a. Ritlecitinib (n=261, King 2023)

i.SALT≤20 at week 24 was achieved by 23% (50mg QD) and 1.6% (placebo) of patients; SALT≤10 at week 24 was achieved by 13.4% (50 mg QD) and 1.5% (placebo) of patients.

ii. TEAEs were reported by 75% of patients on 50 mg QD ritlecitinib and 71% on placebo group. Discontinuations were reported by 2% of patients in both groups. Most common AEs (occurred in ≥10% of patients) were upper respiratory tract infection, nasopharyngitis, and headache. b. Deuruxolitinib (n=706, King 2024):

iii. SALT ≤20 after 24 weeks was achieved by 42.5% (8 mg BID), 56.8% (12mg BID), 1.8% (placebo) of patients with partial hair loss and by 20.1% (8 mg BID), 29.5% (12 mg BID), 0% (placebo) of patients with complete or near-complete hair loss.

iv. TEAEs related to study drug were reported by 31.3% (8 mg BID), 34.9% (12 mg BID), 22.1% (placebo). Most TEAEs were mild to moderate. Headache, acne, and increased blood creatinine phosphokinase were the most common TEAEs (occurred in ≥5% patients). No heart-related AEs were reported.