Pfizer attacks Lilly’s Jak in alopecia

Watch out, Lilly: Pfizer is after you in alopecia. The latter reported positive top-line data today from the phase 2/3 Allegro trial of its Jak 3/Tec inhibitor ritlecitinib in the autoimmune disease, bringing it in line with Lilly and Incyte, which have already posted wins with their Jak inhibitor Olumiant in the Brave-AA1 and AA2 trials. Pfizer has left out the details for now, so investors will want to see how ritlecitinib stacks up against its rival. All the studies primarily evaluated the proportion of patients achieving a severity of alopecia tool (Salt) score of 20 or less; the Brave trials at 36 weeks and Allegro at 24 weeks. Safety, currently a concern with Jaks, will also be under the microscope. Pfizer said that ritlecitinib’s safety profile was consistent with previous studies, adding that there had been no major adverse cardiac events, a worry since the findings from a post-marketing study of Pfizer’s approved Jak Xeljanz. One question for Lilly is whether the 4mg dose of Olumiant will get the go ahead: in the US, only a 2mg dose is approved for rheumatoid arthritis. Concert’s Jak inhibitor CTP-543 is also in phase 3 in alopecia, with data due next year.

Can ritlecitinib challenge Olumiant in alopecia? Data from Brave-AA1 & AA2
% of pts achieving Salt ≥20 at wk36 Olumiant 4mg/day Olumiant 2mg/day Placebo
Brave-AA1 35% 22% 5%
Brave-AA2 33% 17% 3%
Salt 20: 20% or less scalp hair loss; Source: Company release.

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