Litfulo vs Olumiant: How do they compare?

Key Points

• Litfulo (ritlecitinib) and Olumiant (baricitinib) are two oral kinase inhibitors.
• Olumiant is used to treat rheumatoid arthritis, COVID-19, and alopecia areata in certain adults, while Litfulo is used to treat alopecia areata in people 12 years and older.
• Litfulo comes as a capsule and Olumiant comes as a tablet. Both medications are taken by mouth once a day.

Litfulo (ritlecitinib) and Olumiant (baricitinib) are both oral medications that may be used to treat certain inflammatory conditions. Olumiant is a Janus kinase (JAK) inhibitor, and Litfulo inhibits JAK3 and the TEC kinase family. Both medications work by lowering inflammation.

Litfulo is approved to treat:

• Alopecia areata (AA)

Olumiant is approved to treat:

• Rheumatoid arthritis (RA)
• COVID-19
• Alopecia areata

What is the typical dosage for Litfulo and Olumiant?

Both Litfulo and Olumiant are taken by mouth once a day. Litfulo is available as an oral capsule. The typical dose of Litfulo is 50 mg by mouth once a day. Olumiant comes as an oral tablet, and the dose depends on the reason you are taking it:

• Rheumatoid arthritis: The typical dose is 2 mg by mouth once daily.
• COVID-19: The typical dose is 4 mg by mouth once daily for up to 14 days,
• Alopecia areata: The typical dose is 2 mg by mouth once daily. The dose may be increased to 4 mg once a day.

Is Litfulo or Olumiant more effective for alopecia areata?

There currently are no head-to-head clinical trials that compare Litfulo and Olumiant. Both medications were studied for the treatment of alopecia areata in separate clinical trials.

After taking Litfulo for 24 weeks, 23% of participants had 20% or less of scalp hair loss and about 13% had 10% or less of scalp hair loss. This was compared to around 1-2% of those taking a placebo (no active medication).

In clinical trials of Olumiant, up to 35% of participants had 20% or less of scalp hair loss at 36 weeks compared to up to 5% of those taking a placebo. Additionally, up to 13% of participants taking Olumiant had 10% or less of scalp hair loss at 36 weeks, compared to 1-4% of the placebo groups.

Researchers used the same tool to determine how well these medications worked, called the Severity of Alopecia Tool (SALT). However, the effects of Litfulo and Olumiant were assessed after different amounts of time. More research is needed to know how these medications compare to each other for treating alopecia areata.

How do the side effects of Litfulo and Olumiant compare?

The most common side effects (≥ 5%) in clinical trials of Litfulo include:

• Headache
• Diarrhea
• Acne
• Rash

Side effects vary depending on why you are taking Olumiant. In clinical trials with Olumiant, the most common side effects (≥ 5%) in clinical trials included:

• Upper respiratory tract infection
• Abnormal liver enzymes
• Headache
• Acne
• High cholesterol

Both Litfulo and Olumiant contain a Boxed Warning about serious infections, mortality, malignancy, major adverse cardiovascular events, and thrombosis. A Boxed Warning is the FDA’s strictest safety warning for a medication.

• Serious infections: Litfulo and Olumiant affect your immune system and can make it harder for your body to fight off infections. Tell your healthcare provider if you notice any signs of symptoms of an infection, such as fever, chills, muscle aches, cough, diarrhea, or pain with urination.
• Mortality and major adverse cardiovascular events: The use of JAK inhibitors for RA has been associated with a higher risk of death and major adverse cardiovascular events in certain people.
• Malignancy: Some cancers were observed in clinical trials of Litfulo and Olumiant, such as skin cancer and lymphoma.
• Thrombosis: Some people taking Litfulo or Olumiant developed blood clots. This can be life-threatening, so these medications are not recommended for people who are at a higher risk of blood clots.

This is not a complete list of side effects, precautions and warnings associated with Litfulo (ritlecitinib) and Olumiant (baricitinib). The types or incidence of side effects may be different for you. Discuss these topics with your healthcare provider.

Which is more affordable, Litfulo or Olumiant?

There are currently no generic versions of Litfulo or Olumiant. Both medications are brand name only, which can be more expensive.

Compare prices, coupons, and patient assistance programs for these medications below:

• Litfulo Price Guide
• Olumiant Price Guide

Your insurance may help pay for these medications. Call your prescription benefit company to find out if Litfulo or Olumiant are covered under your plan and to find out your copay amount.

This is not all the information you need to know about Litfulo (ritlecitinib) and Olumiant (baricitinib) for safe and effective use and does not replace your doctor's instructions. Review the full product information, and discuss this information with your healthcare provider.