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NICE recommends first-ever treatment for alopecia

The first treatment for severe alopecia areata has been recommended by NICE for use on the NHS.

The first treatment for severe alopecia areata has been recommended by NICE for use on the NHS.

The one-a-day tablet, ritlecitinib (Litfulo), reduces the enzymes that cause inflammation and subsequent hair loss at the follicle.

NICE has recommended a 50mg dose of ritlecitinib for people aged 12 and over with severe alopecia areata.

The effect of alopecia areata on patients

Alopecia areata is an autoimmune disease which affects roughly 2% of the world’s population, with around 400,000 people affected in the UK alone. The disease can cause hair loss on the scalp and face, as well as other areas such as arms and legs.

Most people with alopecia lose hair in circular, coin-sized patches on the scalp, but in more severe cases, they may lose all their hair.

Alopecia areata can begin at any age but most individuals develop it early in life. Research suggests women are more likely to develop the condition than men, with some studies finding a higher prevalence amongst Asian, Black and Hispanic individuals.

The risk of developing alopecia areata increases if you have a close relative with it, particularly if that relative lost their hair before age 30.

Anxiety and depression are common psychological problems in patients with alopecia areata. The condition can also leave patients with a reduced ability to regulate their body temperature and make them more vulnerable to infection.

Ritlecitinib more effective than placebo at improving hair growth

Evidence from clinical trials shows that ritlecitinib is more effective than placebo at improving hair regrowth. One study showed that nearly 35% of participants taking ritlecitinib saw significant hair regrowth that covered 80% or more of their scalp after 24 weeks (vs 1.6% taking a placebo).

At one year, 40% of patients taking ritlecitinib achieved 80% or more scalp hair regrowth, with positive responses continuing for up to two years.

Ritlecitinib was not initially recommended for use on the NHS, but following a public consultation, Pfizer (the manufacturer) agreed to provide a discount on the treatment. NICE has now found the treatment to be clinically beneficial and cost effective for NHS use.

Helen Knight, director of medicines evaluation at NICE, said: “Our committee heard how severe alopecia areata can have a significant impact on people’s health and quality of life. I’m delighted that we are now able to recommend this innovative treatment, the first time a medicine for severe alopecia areata has been recommended by NICE for use in the NHS.

“It is especially pleasing that we have been able to recommend ritlecitinib just 16 weeks after it was granted a licence by the Medicines and Healthcare products Regulatory Authority (MHRA), demonstrating NICE’s commitment to getting the best care to patients fast.”

A ‘huge moment’ for the alopecia community

Alopecia UK has welcomed the approval and says it represents a “huge moment” for the alopecia areata community.

Alopecia UK CEO Sue Schilling said: “I am proud of the key role Alopecia UK has played in advocating for this treatment to be made available via the NHS.

“I thank our volunteers who took part in this appraisal process and thank the Committee for their work on reaching this decision, which I am sure will be life-changing for some.”

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