Abstract: Objective: To evaluate the efficacy and safety of ritlecitinib in the treatment of adult alopecia areata in real-world practice. Methods: A retrospective analysis was performed on the clinical data of 10 adult patients with alopecia areata who received ritlecitinib treatment in our hospital from December 2023 to December 2024. Changes in the Severity of Alopecia Tool (SALT) score, Dermatology Life Quality Index (DLQI) score, Alopecia Areata Symptom Impact Scale (AASIS) score, and self-rated sleep status score were compared before treatment and at 4, 8, 12, and 16 weeks after treatment. Adverse reactions during treatment were recorded. Results: Compared with the baseline, the SALT scores at 4, 8, 12, and 16 weeks after treatment decreased by 1.1%, 25.3%, 46.5%, and 63.7% respectively; the improvement in quality of life was 0%, 0%, 29.2%, and 68.8% respectively; the improvement in alopecia areata-related symptom impact was 6.5%, 4.7%, 41.7%, and 49.4% respectively; and the improvement in sleep quality was 0%, 7.1%, 11.9%, and 18% respectively. During the follow-up period, some patients experienced mild adverse reactions, all of which improved after symptomatic treatment. Conclusion: Ritlecitinib has good efficacy and safety in adult alopecia areata, and can significantly improve the severity of hair loss, quality of life, alopecia areata-related symptoms, and sleep quality in patients.

Key words: ritlecitinib, adult alopecia areata, real world