USA: Ritlecitinib and brepocitinib both showed an significant improvement in scalp alopecia areata (AA) biomarkers, finds a recent study.
According to the study which was published in The Journal of Allergy and Clinical Immunology, improvement in the Severity of Alopecia Tool (SALT) scores was positively associated with expression of Th1 markers for both ritlecitinib and brepocitinib and negatively associated with expression of hair keratins. In simpler words, for patients with alopecia areata (AA) treatment with ritlecitinib and brepocitinib associated with improvements in the lesional scalp transcriptome.
Janus kinase (JAK) inhibitors for the treatment of alopecia areata have shown encouraging results in small, uncontrolled studies and case reports. Alopecia areata is an autoimmune form of hair loss. Emma Guttman-Yassky, Icahn School of Medicine at Mount Sinai, New York, NY, USA, and colleagues conducted a biopsy sub-study during the randomized, double-blind, placebo-controlled first 24 weeks of a phase 2a clinical trial. The biopsy sub-study evaluated the efficacy and safety of ritlecitinib, an inhibitor of JAK3 and the tyrosine kinase expressed in hepatocellular carcinoma (TEC) kinase family, and brepocitinib, an inhibitor of tyrosine kinase 2 (TYK2)/JAK1 in the treatment of AA.
The study included 46 patients participated 18 from ritlecitinib, 16 from brepocitinib, and 12 from placebo groups. Change in biomarkers in lesional scalp biopsies between baseline and weeks 12 and 24 was an exploratory endpoint. The researchers also evaluated correlations of biomarkers with hair regrowth, measured using the SALT.
Key findings include:
· At week 24, both ritlecitinib and brepocitinib demonstrated improvement exceeding 100% in the lesional scalp transcriptome toward a nonlesional profile.
· At week 12, the improvements in scalp tissue were greater with brepocitinib than ritlecitinib; however, at week 24, the improvements were greater with ritlecitinib.
"For both ritlecitinib and brepocitinib, improvement in the SALT scores was positively associated with expression of Th1 markers and negatively associated with expression of hair keratins," wrote the authors. "Larger, long-term clinical trials are warranted."
Reference:
The study titled, "Ritlecitinib and brepocitinib demonstrate significant improvement in scalp alopecia areata biomarkers," was published in The Journal of Allergy and Clinical Immunology.
DOI: https://doi.org/10.1016/j.jaci.2021.10.036