Doctor wants to switch me from Tofacitinib to Ritlecitinib (Litfulo)

Hello everyone. My doctor advised to change medications as seen from the title. I’ve had full regrowth on Tofacitinib with spots here and there mostly on my facial hair. I’ve had a very bad flare up recently and my doctor wants me to switch to Litfulo. She says I can switch from one day to the next without needing to ween off Tofa. Like everyone else, I’m scared I’m going to lose everything again on Litfulo. She assured me that I should be fine since the pill is extended release, and it targets the same JAK pathway as Tofacitinib. Now I’m stuck with constant worrying and uncertainty. Can anyone share their experiences switching meds? Specifically these two that I mentioned. Thank you everyone. 

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Permalink Reply by Villa fan on April 5, 2025 at 2:45am

Hi,

I've done it 6 months ago, and it worked fine thankfully, without any loss.

Permalink Reply by kim on April 5, 2025 at 7:42pm

You will be fine. She is right. I take Olumiant.

Permalink Reply by sals on April 6, 2025 at 3:56pm

I am also on Tofacitinib 20mg dose, but it has become less effective over the last 3 or 4 years.  One of my doctors recommended switching to olumiant 4mg. I still have most of my scalp hair, eyebrows and eyelashes but they have become sparse and diffuse. Have you switched from tofacitinib to olumiant and if so how was the process? Meaning more or less effective than tofacitinib?

Permalink Reply by kim on April 7, 2025 at 12:31pm

Olumiant works, I have Alopecia Universalis and my hair is continuing to grow back.

The transition will not cause hair loss.

Permalink Reply by tomasz777321 on April 9, 2025 at 11:31am

Tofacitinib doesnt target exactly the same pathway as Ritlecitinib. Tofacitinib works broader by inhibiting JAK1/JAK3 an partially JAK2, RItlecitinib works only on JAK3, so there is possibility that results not will be maintain sadly during transition.

Also sheeding after switching medication doesnt need to occur exactly after change but it can happen after for example few weeks or months.

Permalink Reply by kim on April 9, 2025 at 12:36pm

Olumiant is Baricitinib. What about that?

Permalink Reply by tomasz777321 on April 9, 2025 at 1:00pm

Baricitinib is JAK1/JAK2 inhibitor and 4mg of it in clinical trials showed superior efficacy compared to ritlecitinib and tofacitinib. I took Litfulo 50mg (JAK3), Leqselvi 12mg in clinical trials (JAK1/JAK2) and right now I'm taking Rinvoq (JAK1).

From my experience those inhibitors highly selective towards JAK1 are the best and they show efficacy in cases refractory to other drugs. Rinvoq shows efficacy in cases refractory to Olumiant and Litfulo (I took Liftfulo and it is the only drug that didnt work on me, I have AU). Those drugs with JAK1 inhibiton works broader than JAK3.

Look at the screenshot below. Litfulo (Ritlecitinib) works very narrow. Beside it, it matter how strong it works on certain kinases, for example Rinvoq (JAK1) works stronger on JAK1 that Olumiant (JAK1/JAK2).

Its very individual matter how it will work.

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