{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T12:13:51Z","timestamp":1793103231714,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T00:00:00Z","timestamp":1766620800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T00:00:00Z","timestamp":1766620800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Alopecia areata (AA) is a chronic autoimmune disorder characterized by refractory non\u2010scarring hair loss. Although baricitinib revolutionized AA management, some severe cases remain refractory. Ritlecitinib, an oral selective dual JAK3 and tyrosine kinase expressed in hepatocellular carcinoma (TEC) family kinase inhibitor, is a recently approved therapeutic agent for the treatment of severe AA. Although clinical trials have established the benefit of ritlecitinib, real\u2010world data on its outcome and safety, particularly in patients previously exposed to baricitinib, have been still limited. Accordingly, we conducted a single\u2010center, retrospective study of 22 severe AA patients treated with ritlecitinib 50\u2009mg daily for 24\u2009weeks at Tohoku University Hospital, Japan. Nine patients (41%) were JAK inhibitor (JAKi)\u2010na\u00efve, and 13 (59%) had previously received baricitinib for a median of 19\u2009months. JAKi\u2010na\u00efve patients were significantly younger (median 14 vs. 38\u2009years;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0143) and had shorter current AA episodes (median 20 vs. 68\u2009months;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0138), compared with the JAKi\u2010experienced group. Baseline SALT score in each group showed similar distribution. At Week 24, all JAKi\u2010na\u00efve patients achieved SALT\n                    <jats:sub>50<\/jats:sub>\n                    (a decrease of at least 50% from baseline in the SALT score); 7\/9 (78%) attained SALT \u2264\u200920 and SALT\n                    <jats:sub>75<\/jats:sub>\n                    (a decrease of at least 75% from baseline in the SALT score). In contrast, among JAKi\u2010experienced patients, only 3\/13 (23%) achieved SALT\n                    <jats:sub>50<\/jats:sub>\n                    , and 1\/13 (8%) reached SALT\n                    <jats:sub>75<\/jats:sub>\n                    , whereas a reduction in SALT score from baseline was observed in 7 of 13 (54%). Importantly, no patients in both groups experienced SALT worsening or treatment\u2010related adverse events. Our findings highlighted that ritlecitinib is highly effective especially in adolescent JAKi\u2010na\u00efve AA, and although the clinical effect may be limited in JAKi\u2010experienced patients, switching from baricitinib to ritlecitinib remains one of the viable options due to its low risk of disease exacerbation.\n                  <\/jats:p>","DOI":"10.1111\/1346-8138.70123","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T06:09:31Z","timestamp":1766729371000},"page":"470-477","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Ritlecitinib in Alopecia Areata: A 24\u2010Week Real\u2010World Experience Contrasting\n                    <scp>JAK<\/scp>\n                    Inhibitor\u2010Na\u00efve and\n                    <scp>JAK<\/scp>\n                    Inhibitor\u2010Experienced Patients"],"prefix":"10.1111","volume":"53","author":[{"given":"Toshiki","family":"Okazaki","sequence":"first","affiliation":[{"name":"Department of Dermatology Tohoku University Graduate School of Medicine  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1061-356X","authenticated-orcid":false,"given":"Takehiro","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Dermatology Tohoku University Graduate School of Medicine  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3908-4339","authenticated-orcid":false,"given":"Moyuka","family":"Wada\u2010Irimada","sequence":"additional","affiliation":[{"name":"Department of Dermatology Tohoku University Graduate School of Medicine  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mana","family":"Sekine","sequence":"additional","affiliation":[{"name":"Department of Dermatology Tohoku University Graduate School of Medicine  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Dermatology Tohoku University Graduate School of Medicine  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Chiba","sequence":"additional","affiliation":[{"name":"Department of Dermatology Tohoku University Graduate School of Medicine  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emi","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Department of Dermatology Tohoku University Graduate School of Medicine  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Shido","sequence":"additional","affiliation":[{"name":"Department of Dermatology Tohoku University Graduate School of Medicine  Sendai 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