Litfulo (Ritlecitinib) is a drug approved for severe alopecia areata and was approved in January 2023.  But this is a drug they accidentally found may actually help Celiac patients….let’s discuss.

A patient with celiac disease began taking Tofactinib for their alopecia.  The patient returned to a gluten containing diet.  Their celiac disease remained in remission. 

In July 2024, a study proved the effectiveness of tofacitinib. It should be used as a treatment option for refractory celiac disease type 2. Study -> https://www.healio.com/news/gastroenterology/20240708/extended-tofacitinib-use-led-to-complete-clinical-response-in-refractory-celiac-disease

Ritlecitinib and Tofactinib are both JAK3 inhibitors.  These JAK3 inhibitors reduce the production of pro-inflammatory cytokines.  Cytokines are the part of the immune system that makes you feel bad when you have been glutened.  

Researchers performed blood tests on the patients. These patients participated in the Phase 2 and Phase 3 study of Ritlecitinib for celiac disease. Know that the celiac tests were done after all of the other alopecia testing had been completed.  Study Link -> https://mayoclinic.elsevierpure.com/en/publications/ritlecitinib-a-jak3-tec-inhibitor-modulates-the-markers-of-celiac

The patients did not know they might have celiac disease at the time of initial testing. They also were unaware during follow-up testing. They continued a gluten-containing diet.

At baseline, researchers found 21 patients with positive TTG IGA tests. Fifteen of these patients were in the drug group and only three were in the placebo group.**  When researchers looked at follow up blood tests, the patients in the Ritlecitinib group had their TTG IGA drop significantly. The patients in the placebo group had significant change to the TTG IGA. 

Pfizer is taking this one step further and has an active clinical trial to further test Ritlecitinib with celiac patients. The trial is currently going on at Massachusetts General Hospital in Boston.  Here is a link. https://clinicaltrials.gov/study/NCT05636293?intr=ritlecitinib&cond=Celiac%20Disease&rank=1