What to learn about Litfulo, a brand new alopecia therapy for adolescents and adults


New treatment for severe alopecia has won Food and Drug Administration approval seal of approval June 23. The drug, which is called Litfulo (with the generic name ritlecitinib), is the first and only FDA-approved alopecia medication for children 12 and older, in addition to adults.

Alopecia areata is a disorder in which the immune system attacks hair follicles, causing severe hair loss. This autoimmune disease often develops in young people, usually between the teens and thirties, depending on the National Institutes of Health. It affects about 2% of the world’s population and, in the United States alone, about 6.7 million people, or one in 500 to 1,000 with alopecia areata. Until now, we didn’t have a drug for teenagers and there was only one approved treatment option for adults with severe disease.

Many people with alopecia develop circular bald patches on their scalp, although this can also lead to hair loss on the arms, legs, eyebrows and eyelashes – really, anywhere on the body, according to United States National Library of Medicine.

It can have a huge effect on a person’s quality of life, especially when they feel complex and embarrassed by their appearance. Teenagers, in particular, are often excluded, teased and bullied by their peers because of their hair loss. People with alopecia often report feeling frustrated with the lack of treatment options. Many have tried off-label therapies, such as topical steroids, with varying results, and which can lead to potential side effects, including acne and glucose intolerance.

Litfulo may very well change that for at least some people with alopecia areata. According Pfizer, the maker of the drug, it is specifically designed for severe cases, or those who have lost 50% of their scalp hair due to the disease. And clinical trials show that it can work well…Really GOOD. In the Pfizer study, 718 people took the drug, given via a pill, once a day at a dose of 10, 30 or 50 milligrams for 24 weeks, after previously taking a daily dose of 200 mg or a pill placebo for 24 weeks. After five and a half months, up to 31% of people who started out with a minimum of 50% hair loss and received the 50 milligram dose (after one month of taking 200 mg daily, rather than the placebo) increased to 20% hair loss, or 80% or more scalp coverage.

As the study continued for 48 weeks, the number of people experiencing significant hair regrowth continued to increase. Some people’s eyebrows and eyelashes grew back, and other participants who were nearly bald from the disease grew full hair.

Pfizer expects Litfulo to be available within weeks. One important thing to note: It’s far from cheap — the one-year supply is priced at $49,000 — but the outlay will vary depending on what kind of health insurance you might have, said a Pfizer spokesperson to SELF.

Here’s how the drug works and why some dermatologists say it’s a quantum leap for people with alopecia.

Litfulo stimulates hair growth by calming part of the immune system.

You have about 5 million hair follicles on your body, and more than 100,000 of them, on average, are located on your scalp. At any one time, 90% of the follicles in your head are growing while the remaining 10% are in a resting phase where new hair does not grow. Anthony Oro, MD, PhD, Eugene and Gloria Bauer Professor of Dermatology at Stanford Health Care, tells SELF. Throughout your life, your hair goes through this growth cycle every two to six years (which is why some people are able to grow their hair to their waist).

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