Pfizer is the world’s biggest research-based pharmaceutical company. They’re responsible for some of the most successful medications in circulation — including the first UK-approved Covid-19 vaccine.
In June 2023, Pfizer received approval from the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for its alopecia medication, ritlecitinib (brand name Litfulo). The UK’s Medicines and Healthcare products Regulatory Agency (MHRA) followed suit, approving Litfulo in November 2023.
But Pfizer’s alopecia drug also hit the headlines in 2022 for an entirely different reason. Pfizer sponsored the 2022 Oscars, leading conspiracy theorists to claim that the now-infamous Will Smith/Chris Rock incident was a staged publicity stunt to promote Pfizer’s alopecia medication. Rock’s joke, after all, made light of Jada Pinkett-Smith’s hair loss condition.
However, this theory isn’t true [1].
So what do we know about ritlecitinib? In this article, you’ll learn:
Litfulo™ (ritlecitinib) is a drug designed to help stimulate hair growth in people who have alopecia areata and other hair loss conditions caused by an autoimmune disease.
Back in 2018, this Pfizer alopecia drug was given Breakthrough Therapy status by the FDA, thanks to its significance as a potential treatment for alopecia.
Ritlecitinib is a Janus kinase (JAK) inhibitor that’s taken once a day as an oral tablet. JAK inhibitors block immune response signals, essentially suppressing the immune system to avoid an unnecessary autoimmune response.
An autoimmune response happens when the body overreacts to a trigger, and the immune system attacks its own cells. Alopecia areata is an autoimmune condition in which white blood cells attack the hair follicles. Alopecia totalis (AT) and alopecia universalis (AU) are related conditions. AT results in near or total scalp hair loss whereas AU results in complete loss of hair on the scalp and the body.
Ritlecitinib blocks signals from molecules and immune cells that are linked with alopecia areata symptoms [2]. It’s a highly selective JAK inhibitor, which means it can target more specific enzymes than other drugs in this category. Researchers suggest this may lead to fewer side effects than other JAK inhibitors, making it a highly anticipated treatment [2].
Yes — ritlecitinib is now available on the NHS as a treatment for alopecia areata. So if you’ve been struggling with autoimmune hair loss, it may be time to revisit your GP to see if you’re eligible for this treatment.
That said, it can take time for new medications to become available in all areas, so Alopecia UK — a charity that supports those with hair loss — has warned that Litfulo may not be immediately accessible [X].
In addition, bear in mind that because ritlecitinib suppresses the immune system, it’s not suitable for everyone. This particularly impacts those at risk of developing certain types of cancer or infection. Your doctor (or a qualified trichologist) will assess your general health before prescribing ritlecitinib for alopecia areata.
Clinical trials show significant improvements in hair loss for alopecia patients taking ritlecitinib [3]. One trial examined results in 719 people who each had at least 50% hair loss as a result of alopecia areata, alopecia totalis, or alopecia universalis.
After 6 months of taking ritlecitinib, a statistically significant proportion of patients experienced hair regrowth to at least 80% scalp hair coverage, compared with just a handful of patients taking the placebo.
A study from 2021 found that 50% of enrolled alopecia areata patients had reduced their SALT score by 30% within six months. (The SALT score measures the percentage of scalp hair lost to alopecia areata, with 0 being zero hair loss and 100 being total scalp hair loss) [4].
Following these strong results as well as those from earlier trials, several medical bodies across multiple countries have now approved Litfulo for treating alopecia areata.
Like all medicines, ritlecitinib has several known side effects. An earlier study found that two-thirds of ritlecitinib trial patients experienced at least one adverse effect, although the majority were mild [4].
Side effects of ritlecitinib include:
There was also one case of pulmonary embolism, and 2 patients developed breast cancer during the trial, although it’s unclear if this was linked with the alopecia drug.
Other JAK inhibitors are known to be linked with cancer and heart problems. The FDA has previously issued a warning to medication users to highlight these potentially serious side effects [5].
Ritlecitinib can impede the immune system’s ability to fight infection, so some people may be more susceptible to developing serious infections.
Individuals who are sick with an infection are advised to temporarily stop taking ritlecitinib until their infection has cleared.
Adults and adolescents (individuals aged between 12-17 years old) can take ritlecitinib for treatment of their severe alopecia areata. The approved recommended dosage of ritlecitinib is 50 mg which can be taken orally once a day.
Before Litfulo, there were very few approved treatments for autoimmune-related hair loss conditions like alopecia areata. Hair transplants for alopecia areata aren’t usually recommended, either. So it’s great news that pharmaceutical companies are actively researching and trialling new treatments for these conditions.
In 2022, the FDA also approved Olumiant, the first systemic treatment for alopecia areata. So this is clearly a priority for pharmaceutical organisations at the moment.
New treatments are being discovered, tested, and approved to give alopecia patients more treatment options in future. In one study, ritlecinib was compared with brepocitinib — another JAK inhibitor that also suppresses the tyrosine-protein kinase 2 enzyme (TYK2) — and found the latter to be more effective [4]. So continuing trials may establish even more effective treatments in the near future.
If you’re currently experiencing alopecia areata — or another type of unexplained hair loss — it’s important to seek help from a professional trichologist. They can carry out hair loss blood tests and other hair and scalp examinations to determine the root cause of your condition. They can then find the right treatment for you based on your diagnosis.
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