1. Ritlecitinib and brepocitinib demonstrate significant improvement in scalp alopecia areata biomarkers
- Author
-
Lori Ann Cox, Ana B. Pavel, Weidong Zhang, Ester Del Duca, Martin E. Dowty, Yeriel Estrada, Elena Peeva, Karen Page, Anindita Banerjee, Brett A. King, Linda Zhu, Christopher Banfield, Michael S. Vincent, Aisleen Diaz, Emma Guttman-Yassky, and Ning Zhang
- Subjects
medicine.medical_specialty ,Alopecia Areata ,Immunology ,Gastroenterology ,Internal medicine ,Biopsy ,medicine ,Humans ,Janus Kinase Inhibitors ,Immunology and Allergy ,Protein Kinase Inhibitors ,Scalp ,integumentary system ,medicine.diagnostic_test ,business.industry ,Alopecia totalis ,Alopecia ,Alopecia areata ,medicine.disease ,medicine.anatomical_structure ,Hair loss ,Tyrosine kinase 2 ,Alopecia universalis ,Janus kinase ,business ,Biomarkers - Abstract
Background Janus kinase (JAK) inhibitors have shown encouraging results in the treatment of alopecia areata (AA), an autoimmune form of hair loss, in small, uncontrolled studies and case reports. Objective To conduct a biopsy sub-study during the randomized, double-blind, placebo-controlled first 24 weeks of a phase 2a clinical trial that 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. Methods Change in biomarkers in lesional scalp biopsies between baseline and weeks 12 and 24 was an exploratory endpoint, and 46 patients participated from the ritlecitinib (n = 18), brepocitinib (n = 16), and placebo (n = 12) groups. Correlations of biomarkers with hair regrowth, measured using the Severity of Alopecia Tool (SALT) score, were also evaluated. Results 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. Conclusions 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. Larger, long-term clinical trials are warranted.
- Published
- 2022