Executive summary (TA958 in one minute)
- Scope: NICE TA958 recommends ritlecitinib for severe alopecia areata in people 12 years and over within its marketing authorisation, via specialist pathways.
- Practical implication: severe cases—especially adolescents—should be referred early to dermatology, with severity/impact clearly documented.
- Commissioning: access is via local criteria; there is typically a commercial arrangement/patient access scheme underpinning NHS use.
What to include in the referral letter (triage-friendly)
- Age, onset, and rate of progression; scalp vs eyebrow/beard involvement.
- Any prior episodes and response (if treated).
- Psychosocial/QoL impact (school/work, social withdrawal, mood symptoms).
- Photos (with consent) and any available severity scoring used locally.
Specialist initiation and monitoring
Ritlecitinib is an immunomodulatory therapy with monitoring and infection risk considerations; initiation is specialist-led under local policies.
Frequently asked questions
Is TA958 only for adults?
No—TA958 covers people aged 12 and over, aligning with marketing authorisation, via specialist pathways.
What should I do in primary care today?
Confirm likely alopecia areata (and exclude obvious mimics), counsel, support wellbeing, and refer severe/progressive or highly distressing disease promptly with clear severity/impact documentation.
Transparency
This page is an educational, clinician-written summary of publicly available NICE guidance intended for trained healthcare professionals. It uses original wording (not copied text) and should be used alongside the full NICE source, local pathways, and clinical judgement. Doses provided are for general reference; always check the BNF/SPC.