Ritlecitinib (LITFULO) Now approved in Canada for Treating Severe Alopecia Areata

Pfizer Announces Health Canada Approval of Ritlecitinib

Pfizer announced today the Health Canada approval of ritlecitinib (LITFULO) for treatment of severe alopecia areata in patients 12 and over. The drug belongs to the group of JAK inhibitors which are well known to be effective in treatment alopecia areata. Ritlecitinib is now the first formally approved JAK inhibitor in Canada although other JAK inhibitors have been used off label for many years in treating alopecia in Canada and continue to be used off label including tofacitinib, baricitinib, upadacitinib and others.

The formal approval is important as it marks a commitment from the company and Health Canada to formally study the long term effects of this medication. It is also important as it may lead to the drug being approved by insurance companies in Canada. The hope is that this drug will prove safe and effective in the long term as patients with severe alopecia areata will generally need to take this drug forever. Patients with more mild forms of AA (50-75% loss) might be able to eventually reduce the dose if they have been stable for a long time.

This drug does not help everyone with alopecia but helps a significant proportion. After about 1 year of use, the drug helps about 30 % of patients with severe alopecia areata achieve outstanding results (known as SALT SCORE less than 10) and about about 45% achieve pretty good results (SALT SCORE less than 20). Patients with severe alopecia areata respond slightly less well compared to patients with less severe AA.

Long term side effects are unknown but continue to be studied.

I have discussed this drug in a public webinar several months ago. A recording is found here. All in all, this is an important milestone for Canadians with alopecia areata.