Litfulo

What is Litfulo?

The prescription drug Litfulo (ritlecitinib) is used to treat severe alopecia arundina in adults, adolescents, and children aged 12 years and older.Alopecia isata, also known as autoimmune alopecia, is characterised by patches of hair loss. It usually affects the scalp but can sometimes occur on other parts of the body, such as the eyebrows, eyelashes, and beard.Hair loss is caused by the immune system attacking healthy hair follicles.Litfulo inhibits Janus kinase 3 and other tyrosine kinases. It also inhibits cytokine-induced STAT phosphorylation mediated through JAK3-dependent receptors. It also inhibits immune receptors that are dependent on TEC kinase members. Alopecia isata is characterised by a deregulation of JAK/STAT. Lifulo's actions are believed to inhibit the signalling molecules and immunoglobulins that are associated with hairloss in alopecia.Litfulo, approved by the FDA on June 23, 2023, was the first treatment approved for both adolescents and adults suffering from alopecia aroeata. It belongs to a class of drugs known as covalent kinase inhibitors.

Warnings

Litfulo may increase the risk of serious bacterial infections, such as tuberculosis, fungi, viruses, or opportunistic ones, that can lead to hospitalisation and death. Litfulo shouldn't be used in patients with active TB or serious infections. Before and during treatment, it is important to check for latent tuberculosis. The infection should also be cleared prior to starting Litfulo. During and after treatment, all patients should be closely monitored for any signs or symptoms of infection, including TB.

Janus kinase inhibitors such as Litfulo have been associated with higher rates of mortality from all causes, including stroke, myocardial ischemia, and sudden cardiac death. This is compared to TNF blockers. Litfulo has been associated with thrombosis in patients. JAK inhibitors are also more likely to cause pulmonary embolism and arterial and venous thrombosis than other medications.

In clinical trials, Litfulo was associated with higher rates of lymphoma and non-melanoma (NMSC) skin cancers compared with those who were treated with other medications. Litfulo was found to increase the risk of lung cancer as well as other types of malignancies in smokers who are currently or have been smoking. You should weigh the benefits and risks of ritlecitinib treatment for those who have a malignancy that is not a NMSC successfully treated or cervical cancer. Patients at higher risk of skin cancer should undergo periodic skin exams.

Use with caution in combination with JAK inhibitors or biologic immunomodulators.

It is not advised in severe liver diseases.

Similar/related drugs

Olumiant, Triamcinolone, Minoxidil Topical, Kenalog-40, Baricitinib, and Rogaine

Before you take this drug

Litfulo should not be used if you have an allergy to ritlecitinib or any other inactive ingredient in the capsule. If you experience a hypersensitivity reaction that is clinically significant, discontinue use.

Litfulo may increase your risk for life-threatening medical conditions, such as serious infections, heart attacks or strokes, blood clots, or cancer. Tell your doctor if you've had:

• A weak immune system or chronic infection, such as HIV or hepatitis
• Cancer of any kind
• Chronic lung disease
• Heart problems
• A heart attack, stroke, or blood clot
• Liver disease
• If you have ever smoked
• If you have a scheduled vaccination,

Tell your doctor about any signs of illness, including fever, chills, and muscle aches. Also, tell them if you have skin sores or diarrhoea.Tell your doctor about any recent travel or exposure to tuberculosis. You may have contracted an infection while travelling to certain regions of the world.Before starting Litfulo, your doctor will order blood tests to detect any abnormalities in the laboratory. If any of these symptoms occur, your treatment could be stopped or interrupted.This medicine can increase your risk for certain cancers, such as lung or lymphoma. You should talk to your doctor about this.

Children

It has not been proven that Litfulo is safe for children younger than 12 years old.

Pregnancy

Tell your doctor immediately if you plan to get pregnant. This medicine may harm an unborn child. Ask your healthcare provider to call 1-877-390-3040 if you become pregnant by accident.

Breastfeeding

Inform your doctor if breastfeeding is planned or if you plan to. It is not recommended to breastfeed during the treatment with Litfulo or for 14 hours following the last dose.

How to take Litfulo?

Litfulo should be taken in one 50-mg tablet once daily by mouth.You can take it with or without food.Do not crush, split, or chew capsules. Do not chew, crush, or split capsules.

What happens if I miss the dose?

Take the missed dose as soon you remember.. If you have less than eight hours until the next dose, skip the missed dose. You should not take extra medicine to compensate for a missed dose.It is not expected that temporary treatment interruptions of less than six weeks will result in significant hair loss.

What happens if I overdose?

Overdoses are unlikely to be toxic. Call Poison Help at 1-800-222-1212 or seek emergency medical attention.

What should be avoided?

Avoid getting a "live vaccine". Live vaccines are available for measles (MMR), rubella, mumps (MMR), yellow fever, rotavirus (typhoid), varicella (chickenpox), zoster, and typhoid.

Side effects of Litfulo?

The most common side effects include:

• Diarrhoea
• Find out about
• Rash
• Urticaria
• Folliculitis
• Atopic dermatitis
• Dizziness
• Increases in creatine phosphokinase values and reductions in red cell counts
• Mouth ulcers.

Interaction with other drug

Inform your doctor about any other medication you take, such as:

• Cyp3a substrates include acetaminophen (codeine), diazepam (cyclosporin), and erythromycin.
• Cyp3a-inducers (such as rifampicin).
• Cyp1a2 substrates, including caffeine (clozapine), propranolol and mexiletine

Use with caution in combination with other JAK-inhibitors, biologic immunomodulators, or cyclosporine.This list does not include all possible drugs. Litfulo may interact with other drugs, including prescription, over-the-counter, herbal, and vitamin products. This list does not include all drug interactions.