Bimatoprost

It is 2015, and therefore finally a good time to write about Bimatoprost.  The main reason for this is that at the end of January 2015, Allergan’s phase II clinical trials concerning the use of Bimatoprost for hair loss in humans are scheduled for completion.  It is expected that results will be announced shortly thereafter.

What is Bimatoprost?

Bimatoprost is a synthetic (i.e., man-made) prostamide (= prostaglandin-ethanolamide) analog.   Bimatoprost is sometimes mistakenly called a prostaglandin analog, since prostaglandins and prostamides are structurally similar to each other.

Prostaglandins were originally named due to the mistaken assumption that they were derived from the prostate gland and its secretions.  I have written a number of posts on this blog regarding prostaglandin D2 (PGD2) and prostaglandin E2 (PGE2).  PGD2 is especially important when it comes to hair loss. Bimatoprost is a prostamide F2α analog.  Latanoprost and Travoprost are examples of prostaglandin F2α analogs.

Current Uses for Bimatoprost

While approval for use to grow scalp hair will depend on the upcoming phase 2 clinical trial results (and hopefully Allergan will decide to fund further phase 3 clinical trials), Bimatoprost has already been FDA approved for use in humans for:

  1. Glaucoma and ocular hypertension treatment, approval in 2001 (brand name Lumigan).  Dosage = 1 drop of Lumigan 0.01 percent or Lumigan 0.03 percent depending on source, once daily.
  2. Eyelash growth (lengthening) treatment, approval in 2008 (brand name Latisse).  Dosage = 1 drop of Latisse 0.03 percent, once daily.

Bimatoprost Side Effects

Although there are some significant side effects (e.g., darkening of iris, undereye, eyelash and eyelid), that can occur when using Bimatoprost for the above applications, most seem to be reversible. It is also great to know that people have been using this product in such a sensitive areas as the eye for over a decade now without any large-scale reports of major injuries, nor any class action lawsuits against Allergan.

Will Bimatoprost be a Miracle Treatment for Hair Loss?

Initially when I first read about Bimatoprost a few years ago, I felt that it was going to be inferior to Minoxidil and not worth researching.  For one, eyelash growth type results on scalp hair would be a joke in my opinion.  More significantly, I thought that all Bimatoprost was doing was keeping scalp hair in anagen (growth) phase for a longer duration, and once the androgens/ dihydrotestosterone (DHT) killed the scalp hair, Bimatoprost would no longer have any positive effect.  So my feeling was that all you were getting was a temporary spike in the amount of your hair that was in anagen phase, and a temporary spike in the length of your scalp hair.

However, I have started to doubt my initial skepticism about this. In 2013 Dr. Valerie Randall (who was the keynote speaker at the 2014 ISHRS Conference) and a number of other co-authors published a great study on the successful use of Bimatoprost to grow human hair (in organ culture) and mouse hair (in vivo). The most interesting aspect of the study was that it seems like Bimatoprost  stimulates intercellular signaling pathways and causes keratinocytes to produce increased hair growth as well as melanocytes to produce increased pigmentation. The whole process seems to start in the dermal papilla (which ties in to my recent posts on the University of Calgary’s and Replicel’s work related to dermal sheath cup cells).

It seems like Bimatoprost is not just temporarily keeping scalp hair in anagen phase longer. It is actually altering scalp biology at the cellular level and changing paracrine signaling (cell to cell communication) that may end up increasing protection against the ravages of DHT. According to the study:

Bimatoprost caused individual isolated scalp hair follicles from 10 different people to stay in anagen longer in organ culture, and about one-third more new hair was synthesized over 9 d with 100 and 1000 nM.

Note that the 100nM and 1000nM are dose measures, and much higher than the 0.03% present in Latisse and Lumigan.  Another part of the study concludes that results from 100nM were better than from 10nM, but results from 1000nM were essentially the same as from 100nM. This is kind of the same phenomenon that we see in studies that show the negligible gains from higher and higher doses of Finasteride or Dutasteride.

My feeling is that Bimatoprost may result in slightly superior results to Minoxidil, but nothing extraordinary.  Will this be sufficient for Allergan to fund final stage 3 clinical trials?  I would hope so, considering how well the company has done recently (stock price has almost doubled in the past year), although I wonder if the company’s November 2014 acquisition by Ireland-based Actavis might lead to some delays in the decision making process?




25 thoughts on “Bimatoprost”

  1. My understanding (which may well be wrong) is that PGD2 may be part of the hair loss after DHT has begun it; DHT somehow causes some chain reaction which leads to the production of PGD2, and it’s responsible for some sort of autoimmune-type reaction. I think some people even thought (think?) PGD2 is the real culprit in MPB, and DHT is just the catalyst. Is this true or..?

  2. Osea que cuanto hay que esperar para ver el producto en el mercado??? parece mentira, hay que esperar 3 o 4 años para tener algo que puede llegar a ser inferior o levente superior al finasteride. Que mal que estamos dios mio.

  3. A pgf2 analog (bimatoprost) and a pgd2 blocker would pretty much reverse a person’s hair loss if in the early to mid stages. Let’s hope this is what will be available to us in the future. To 2015 and beyond!!

  4. Daniel, that sounds interesting but I am not sure either!

    Woah, it seems so simple, yet seems so difficult to achieve!! Especially with all these lengthy clinical trial requirements. I would not be surprised if many hair loss forum members cure their hair loss via experimenting with this type of protocol before the FDA approves anything! I would be too nervous about side effects and would never want to purchase any unapproved drugs online, but there are lot of desperate people out there who will go for it.

    1. Hola admin, que novedades pueden llegar a aparecer a lo largo de este 2015??? pilofocus, bimatoprost, puede salir algo nuevo??? de histogen que se sabe, inicia fase 2 en japón cuando??? Gracias.

    1. It’s like this in any drug industry. These things aren’t simple and they take time to develop and pass though FDA tests.

  5. Longer or sooner hair loss will be historia. Re search and trials are being done approaching different ways and we are closer to a success. With a product or through cloning we will gain the hair loss battle. Things about dental health and ppl losing their teeth for ever in the past.

  6. GUSTAVO TENGO ENTENDIDO que replicel inicia fase 2 en 2015, histogen 2015 en japon , shiseido tambien en 2015 por su cuenta y hay una clinica cfs en barcelona que esta probando celulas madre. Entre mitad de este año y fines del año que viene estaran los resultados calculo y si funciona o no. Si con esto no consiguen la cura calculo hay que esperar a tsuji labs. Saludos

    1. La clínica CFS de españa yo también la estoy siguiendo. Será confiable???? ellos hicieron una primera prueba el año pasado y obtuvieron 70% de positivo en el transplante de células madres.

  7. Hola sets como andas? Vos decis que shiseido inicia el experimento por su cuenta como todos sabemos. Pero ellos inician fase 2 o fase 1? Porque replicel ya tiene los resultados de la fase 1 e inician fase 2 como vos tambien dijiste. Si shiseido daria continuidad al experimento de replicel e iniciarian fase 2 con sus reglamentaciones deberíamos tener un producto en el mercado prontamente.

  8. Todos hacen fase2 creo. La fase1 fue solo de seguridad creo. Ojala encuentren la dosis y frecuencia para la cura total. Si no hay q esperar la clonacion u otra cosa.

  9. Que largo que es todo esto dios mio. Solo de pensar que hay que esperar 2 o 3 años mas para ver si sale algo o no, te pone muy nervioso. Es terrible. Lo de la clínica de barcelona los resultados estarán en junio de este año, de ser positivo empienzan a ofrecer su producto en el mismo mes. Eso es lo único cercano. Esperemos un milagro.

  10. Si diego hay que tener paciencia, yo en mi caso tengo 38 años y no tengo alopecia, solo que soy fanatico de los avances medicos y los sigo. el 14 y 15 de enero hay presentacion de replicel creo, quizas haya novedades.

  11. Si está buena la idea, pero no habla de tiempos. Podría llevar décadas en salir al mercado. Siempre la misma historia. Ya estoy cansado de los experimentos en ratones. Cuando te dicen que se está experimentando en ratones es porque un producto comercial va a estar lindo en 2 decadas.

  12. I am actually really getting anxious and sad because there is still nothing available for hairloss and I feel like my hairloss is getting worst.

  13. Es una verguenza. Esto es lo rápido que está avanzando la ciencia. Dos décadas y media desde que salio finasteride y nada nuevo. Todas prueba, ensayos y nada mas que eso. Puras promesas.

  14. Does the Jan 2015 expected results date include the extended time announced after mid-trial results were found disappointing and they began increasing the dosage? Also, in the event Phase 2 is deemed “successful”, will that be the point at which we can then begin requesting docs to prescribe it “off-label” for hairloss (since my understanding is Phase 3 completion would be required before it could be prescribed otherwise)?

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