More Good News on JAK Inhibitors for AA; Mixed News on JAK Inhibitors for AGA

I was 50/50 about writing an entire post on JAK inhibitors, but in the end gave in due to the fact that I usually neglect the 1-2 percent of balding people who suffer from alopecia areata (AA) or the related conditions alopecia totalis and alopecia universalis.  For a majority of these people, JAK inhibitors clearly seem to be a cure assuming there are no long-term side effects.

There are also some new developments in the more controversial JAK inhibitors for androgenetic alopecia (AGA) patients discussion that are worth elaborating.  As is the norm when JAK related news comes out, the discussion in the prior post was taken over by this subject, in no small part due to “nasa_rs”.   I have let him run rampant in the comments section only because he came back after a lengthy break from this blog.  He will be allowed to continue posting the same stuff in the comments to this post, but thereafter I will become stricter.  It should be noted that despite his often repetitive comments, over the years “nasa_rs” has sent me some highly interesting and unique scientific information.  And recently, he was the first one out there to find the good news about Alcaris Therapeutics adding JAK inhibitor trials for AGA patients to their website’s pipeline page.  As a side note, if I recall, “nasa_rs” really did or does work for NASA…a bit of a scary thought.

Two New Studies Support JAK Inhibitors Working on Alopecia Areata (AA) Patients

In 2014, two groundbreaking papers discussed complete reversal of hair loss in alopecia areata patients.  While this was justifiably by far the biggest news of the year in the hair loss world (and widely covered by the global media due to the spectacular before and after patient scalp photos), there was one problem: the first of these two studies only involved one patient of Dr. Brett King (on arthritis drug tofacitinib), and the second only involved three patients of Dr. Angela Christiano (all three on bone marrow cancer drug ruxolitinib).

Two weeks ago, two new larger studies were released that solidified the above findings:

  1. Dr. Angela Christiano’s team from Columbia University in New York found that 75 percent of 12 patients with alopecia areata had successful hair regrowth while on ruxolitinib for between 3-6 months followed by a 3 month follow-up period.  By the end of treatment, average hair regrowth was 92 percent.  Perhaps the best part of the news: “The drug was well-tolerated in all participants, with no serious adverse events.”
  2. Even more significant, a much larger joint study from Stanford University (led by Dr. Anthony Oro) and Yale University (led by Dr. Brett King) found that of 66 alopecia areata patients treated with tofacitinib, 64 percent of patients had a positive response to treatment (and 32 percent achieved an improvement of over 50 percent after only 3 months of therapy). Side effects were generally mild.

From the above studies, it seems like ruxolitinib is better than tofacitinib when it comes to treating alopecia areata.  It remains to be see if results are even better when treatment is continued for a longer duration when it comes to either of the above two drugs. Note that a number of other newer JAK inhibitors will get approved and come onto the market in the US in the coming years.

Finally, for those who do suffer from alopecia areata, this is by far the best place in the internet to connect with others such as yourself.

JAK Inhibitors for Androgenetic Alopecia (AGA)

Some good news, some bad news and some in-between news here.

The Good:

  • First, from the 12 patient study article link I posted in the above section, Dr. Christiano still seems optimistic about JAK inhibitors working for AGA per the following quote:

“The CUMC research team plans to expand their studies to include testing these drugs in other conditions such as vitiligo, scarring alopecias, and androgenetic alopecia (pattern baldness) where they may also show efficacy. “We expect JAK inhibitors to have widespread utility across many forms of hair loss based on their mechanism of action in both the hair follicle and immune cells,” said Dr. Christiano.

The Bad:

  • However, Dr. King who in the past thought that it was worth testing JAK inhibitors (especially topical ones) for AGA now seems pessimistic according to this article:

“King said it is doubtful that Xeljanz (=tofacitinib) will work for the most common types of hair loss (such as male pattern baldness), which are not the result of an autoimmune disease.”

Note that both Dr. Christiano and Dr. King are listed as advisers to Alcaris Therapeutics in the conflict of interest section of the earlier linked 66 patient study summary page.

The In-Between:

  • One important bit of information on JAKs and AGA that never received the attention it should have (partly because I did not cover this subject much in recent months) happened a few months ago when Solomon interviewed Dr. Eddie Wang (who previously worked with Dr. Angela Christiano).  According to Solomon, Dr. Wang “rated JAKs success chance for AGA 5 out of 10“.  Dr. Wang seemed to think that JAKs could be reducing microinflammation in AGA patients and that could help hair growth.  I contacted him about how he came up with this 5/10 estimate, but he never responded.  I would put this development under “good news” if Dr. Wang had responded with a detailed answer.

Two (or More) Variants of AGA?

I have mentioned in the past that it seems like a majority of balding people have significant itching and dandruff in their balding regions, while some balding people have none of those annoyances whatsoever.  I always wonder if the people who have this itching and dandruff associated with their balding also have a significant inflammation (and maybe even autoimmune) component to their hair loss?  If topical JAK inhibitors do end up helping people with AGA, will those with significant itching benefit more?  I would not at all be surprised if researchers some day find that AGA patients can be broadly split into two main camps.

Pharmacologic Inhibition of JAK-STAT Signaling Promotes Hair Growth

Finally, while I discussed this October 2015 study on this blog before as part of a lengthy post, I keep finding new items of interest in there.  I therefore thought it was worth pointing out the study again here in the hopes that some of the readers with a scientific background can give us more feedback on the contents.  Dr. Angela Christiano and Dr. Claire Higgins are both co-authors of this study. Some of the more interesting quotes:

“Hair growth after JAK-STAT inhibition mimics normal anagen initiation by activating the Wnt (Note: this is what Samumed is focusing on) and Shh signaling pathways.”

“JAK-STAT inhibition causes activation of hair follicle (HF) progenitor cells.”  (Note: also see this important patent filed in 2013: “Jak inhibitors for activation of epidermal stem cell populations”).

“Inhibition of JAK-STAT signaling improves skeletal muscle regeneration in aged mice.”

“Tofacitinib treatment promotes inductivity of dermal papilla (DP).”

“In human hair follicle assays, we show that JAK inhibition via tofacitinib treatment increases the growth rate of anagen hair shafts (skin grafts and organotypic culture assays) and enhances the inductivity of human DP spheres (neogenesis assays).  It is surprising that ruxolitinib treatment did not improve the inductivity of human DP spheres, despite the fact that it increased the rate of growth in the organ culture model. We postulate that down-regulation of proapoptotic signals in tofacitinib-treated spheres, which did not occur in ruxolitinib-treated spheres, may promote survival of DP cells, leading to enhanced hair growth in this assay.”

102 thoughts on “More Good News on JAK Inhibitors for AA; Mixed News on JAK Inhibitors for AGA”

  1. I’m still on the fence about jak and AGA , i feel that if it works at all , it will probably not grow more hair then what fin can do . I’m really starting to think that our hair follices are not dormant but actually dead . I think thats why fin and minox only work to the extent they work is because they are just re energizing follicles that weren’t completely dead . Does anyone actually know the real answer to that question ? Has it been scientifically proven are follicles are dormant not dead?

      1. What are progenitor cells and if they’re missing, is it theoretically possible for hair follicle stem cells to become them?

    1. JAK will not do anything mAjor for MPB. We need a cure but the hair loss surgeon crook$ industry will keep suppressing it as long as they can

  2. Thanks admin! It just seems wierd that rogain 15 years ago did so much more for me then it does now . I wish i would had never stopped using it,because now im 40 and it does nothing. You would think that if you stopped using it for 10 years and restarted it , that you would get the same results in the same area , but nothing for me 🙁

  3. Top stuff once again Admin. Thanks so much for keeping us informed.

    Time will tell with JAKs, but I suspect like most baldies, we fear the worst. In my nightmares JAKs are the ultimate cure, working for everyone, except me. This of course will leave me the last bald man on earth, hunted and tormented by the hirsute, with the only consolation been Will Smith procuring a very attractive acting role.

    What ever the outcome for us, I am really pleased for sufferers of AA.

    We shouldn’t get to down. JAKs are only one avenue of attack, and as per your last article, plenty of big financial players entering the game.

    Dr Wangs 5 out of 10 brings back bad memories for me. Many years ago I was chasing this lucrative job and kept harassing the recruitment agent on my chances. Begging and pleading he still would not give me any info so I was reduced to threatening to make public a photo I had of him in a rather uncompromising position. This done the trick, “Terry, keep this quiet, but your chances are between 0 and 100 percent”

    0 to 100 percent sums up hair loss research perfectly.

    I like Nasa. His enthusiasm is great, but like anything, it should be tempered. Reminds me of a bloke I use to know who became so obsessed with global warming he would walk around London with a placard “it will never snow again”. The following month I was outside making a snowman, when he showed up with a new placard “After this blizzard, it will never snow again”. This winter, if I see him again, I will hit him with a snowball.

    Thanks once again Admin

  4. I know of some that have used tofa at different dosages topically and it did not regrow anything at all.. I’m not hyped on jaks inhibitors.

  5. Don’t know why my post was removed, which I posted before anyone else.

    But yeah, I’m sick of seeing these proposed cures over the years yet they always let me down.

    There’s no way they’re going to cure it while I’m young. I can see me being 50 and getting the cure, which will be utterly useless to me then.

    1. I cant say anything for 2017 through 2020 but I’m pretty sure in the next 10 years well have full heads of hair so unless your 40…

      1. I’m 30, and my 20’s was utterly ruined by this crap. I can see my 30’s being ruined as well. I feel so alone.

        I get attention and smiles from attractive women and they seem to want to talk to me, and I can make them laugh, but I can never ask one out, because I just can’t get past the idea that they would never be with a bald guy when they can pick one with a full head of hair.

        1. Focus on bettering yourself in other ways I’ve been running and and doing circuit training for the past couple of weeks every day. I’ve been trying to have a better diet steady antioxidants to take care of my skin and look younger longer that way when I can get my hair back I’ll look my best. I buy new books and try to learn everything and experience everything. Lets be honest right here the reason most of us males really dont like not having hair is because of opposite sex its not that your magic mirror wont say your the fairest its cuz in the back of your mind your saying your the unfairest of them all. I know it’s pretty shitty I hate not having my hair as well and it gets to me but I kinda figure it’s like crying over spilled milk at this time. Picture this 3 years 5 years 10 years 20 years from now cures here you got a thick head of hair you don’t even know what to do with most likely your going to look back and realize all the confident times you wasted obsessing about your scalp. I seriously doubt the woman/man of your dreams is gonna be real attracted when they ask you about your life and you be like well it’s been on hold actually for the last 10 years so haven’t done much but hide from certain social gatherings and became a hat enthusiast now that I have my hair back tho I’m ready to become interesting! Cmon lol the cure will come but don’t just wait…improvise. hope this helped a little 🙂

          1. In honesty im 23 with mpb and I do great with girls, and I still want hair. Not to appease some random women, I want to enjoy my youth and be able to style and give myself different looks. I watch movies and programs and see guys with amazing hairstyles and it sucks knowing i’ll never be able to experiment and have a laugh. I probably look really old to other people instead of 23, and everywhere you look it gets rammed down your throat about how hair makes your personality. Well mpb doesnt define my personality, and i have nothing to prove to anyone. I just long to have lovely thick hair i can run my hands through like a boss.

            1. I’m sure she’s about to explain, being a woman, that hair does matter to them and ridiculously impedes one’s sexual magnetism.

              I cannot understand why something so natural, to even young men, can be so unattractive to both the male looking in the mirror and the female looking on.

              This is why it is a disease and needs scourging from mankind. But I have to ask, if it is possible within the laws of the universe, why hasn’t man found the cure with all the science and intellect at his disposal?

        2. Dude I’m bald with a gorgeous wife 11yrs younger than me. I make her laugh treat her well and have an awesome time in the sack. She loves me being bald and I was also the same with you, but trust me I’d love to have hair but I too see all this talk eventuating into nothing. Don’t let it hold you back ask a girl out you will be surprised.

          1. I’m glad you said that about her being 11 years younger than you.

            There is a 21 year old new girl at work with me and due to the nature of our shifts I am alone talking with her for up to an hour a day and both our work stalls when that happens and we seem to find things to say, we lock eye contact the entire time, she smiles, lights up and laughs a lot when we talk.

            I’m not gonna lie, I looked her up on Facebook and she’s gorgeous in her photos as well but I also spotted her ex in one of them. Basically a guy her age with full head of hair and athletic. Can’t help but think I would stand no chance compared to that.

            But her mother also does certain shifts and seems to like me and thinks I’m a nice guy. She caught us talking today and I kinda knee-jerk reacted by saying I’m just doing X-task (related to the job), so it didn’t seem her baby was being preyed upon by a bald 30 year old, and she laughed affectionately and said, “Oh you’re okay, hunnie!”

            I don’t know how to take it from here. I’ve never asked a girl out. Not one this attractive anyway.

            Sorry Admin, off topic I know but understand my pain! 🙁

  6. Samumed has peaked my interest as of recently. It looks like they are moving forward with their work which is encouraging. Their research looks sound. I’m eager to hear more about it.

    Even getting a product to market soon that simply stops the progression of hairloss without side effects would be a game changer.

    If Samumed’s product can increase density by creating new follicles (as they suggest they can do) as well, that could basically be a cure for many.

  7. Man The only positive I’m getting out of this is that they’re still moving forward with trials for aga. If they knew that this was dead in the water I don’t think they would even advanced any farther. This gives me some hope that they still at least think but this might be able to help our cause. When they stop trialing on aga then we should really be scared!

  8. The lack of progress reminds me of a time I was waitIng for a train but none would stop. I looked around to check the station sign and it said ‘Nowhere’. Shame, I was all suited up and everything.

  9. H
    October 5, 2016 at 11:55 pm

    I cant say anything for 2017 through 2020 but I’m pretty sure in the next 10 years well have full heads of hair so unless your 40…

    Don’t be so sure H… when Spencer K had his show many years ago it was on the phone, you need to call in to listen to the show and he would always say a cure would come “in the next 5 years”
    that was a long time ago.

  10. I’m also hoping for a gray hair cure combined with a hair loss cure. It would be a bit of a double edged sword to get a full head of hair back only for it to be old-man white. Men’s hair dye usually looks awful. In the meantime I do everything I can to stay young so that I can still enjoy life when my full head of hair returns; eating right, exercise, meditation, and strict sun avoidance.

    However, I agree with the others that we can’t just wait for a cure to begin our lives; we need to live for today and work on developing ourselves.

    Also, I agree with what someone else wrote about being happy for AA sufferers. This is huge for them and they must be thrilled. I can’t imagine what it must be like to suffer from AA.

    1. Go back a little further in the post to like page 6 Paul. It is actually not Kelopesia results but a different cream called collegance. Actually looks pretty good… not amazing regrowth, but they definitely had a nice improvement.

  11. I’ve been trying to be hopeful for JAK but it’s so hard since AA seems to be much easier to “cure” than AGA 🙁

    I am a 23 yo girl and I attribute 90% of my low self esteem to my hair loss. My hair started to thin since I was 14 and it has never fully grown back or thickened.
    My life has become so much harder as I spend all day trying to cover the bald patches, which is hard since my hair is thinning in all places of my head. It has made me depressed and anxious.
    I have a relatively normal life and a supportive boyfriend but I will never feel complete without my hair. It’s like something’s always missing, like I have lost my identity and can’t be myself anymore.

    People who notice my hair loss don’t hesitate asking what is wrong with me.. And I don’t understand why someone would do that. I mean, I’m always afraid of saying hurtful things to people but it seems that when it comes to hair loss/baldness, people don’t give a f*ck and make jokes of it. I’ve heard so many bad things from people I liked. They never want to help, they just wanna have a laugh..
    I am not unattractive but I feel like I am less than any other girl that has a lot of hair. 🙁

    I know how you all feel.. it’s a new battle everyday and I hope we can be victorious someday. Stay strong buddies.

    Special thanks to admin for this blog. It’s seriously the only thing that makes me have hope.
    Not 100% hopeful for a cure by 2020 but I think it might come by 2025.


    1. I dunno if this will help at all I’m also 23 and back at my high-school a girl has miniaturized head of hair I mean completely bald except for tiny looks like hair you’d have on your arm hair started maybe 2 years ago. She’s 17 or 18 right now and sometimes wears a wig for like school pictures and stuff but she’s on drill team and wears nothing to hide it while she’s dancing and she looks absolutely stunning with or without.

      1. I’m really sorry you have to endure this terrible affliction.

        It is utterly devastating for a man, but for a woman, I cannot even imagine it.

        This world is so cruel.

        1. Bald30 all your comments in this thread are unrelated to the topic. Once or twice is ok, but soon I will delete and, in future, ban.

          1. I can’t understand why you would do that. More comments means this site gets indexed more in Google. Which means more awareness for baldness and attention from companies who might want to cure it.

            Besides, I was replying to what somebody else said.

  12. I think Tsuji is the most promising but will be another 7 years for that. If something comes out within the next 3 years that can bring me back to NW2 levels I will be happy.

    Anyways, do you guys think I should give in to a SMP procedure? I’m very desperate at this moment.

    1. Same here. I was NW6 by 24 and it utterly ruined my life. I’m 30 now and depressed, filled with anxiety and poor confidence, and it’s killed all my relationship and career prospects.

      I legitimately used to turn heads and have girls approaching me, as well as male peers and respectable adults vying for my attention (Halo Effect is real) so I never learned to have any guile or conversational skills. I didn’t need them. I was destined for life on easy mode… that is until I became afflicted with this terrible disease.

      I would be happy to even go to a NW3 again, over this horrendous NW6. NW2 and NW1 would be like being told your cancer is gone for good. And going back to NW0… that would be like being told your cancer is gone and winning the lottery on top.

      Make it happen, scientists. The overwhelming joy you can bring to millions of men and women alike, would be a karmic explosion all over the world.

  13. 2017 will be the year that will show what works and what doesn’t . So many clinical trials going on that one has to be it. All seem to be tackling different angles. My money is on samumed, after listening to the presentation those guys are shooting for the moon. And if they are not blowing smoke up our arses we will find out this year how good it works along with the rest of them

  14. Thanks for the support guys.
    I actually believe men and women can still be attractive despite their hair loss.. I’ve been attracted to bald guys before.
    But the problem is it ruins our self esteems so much. So even if you are still very good looking after hair loss, you most likely won’t feel attractive at all. You will feel like crap.

    I always think if I had my hair back I would someday want to shave all my head. Just to know how it feels like.. A lot of girls say they feel some kind of freedom when they do that.
    But I would like to do that as an OPTION and not because I need to.
    I wish I had the chance to choose what to do with my hair and not be a prisoner of it instead. 🙁

    Anyway, until the day someone finds the cure we just need to cope.. I always liked Dr. Cristiano better cause she suffers from hair loss like us, so she understands how we feel. Hopefully she won’t be satisfied by curing only one type of baldness.

    Don’t feel bad, guys, we are taking slow steps but we are gonna get there soon.


  15. Admin,

    You might wanna change one minor thing:
    replace the t with an r in the sentence >

    “(all three on bone marrow cancer drug tuxolitinib).”

  16. All of you must have patience and remain calm. Soon all of you will have a new treatment that will regenerate at least 1 to 2 norwood no more. But it will be better than current treatments.

  17. I Am female with pattern baldness, and I’m not gonna lie here….loads of good looking men still chase me and it’s all about having confidence as a person.

    If you guys show you have confidence then women will be attracted.

    1. I only start contemplating about woman’s character after I asses that physically she’s attractive enough for me to be satisfied.

      I’m sorry but as a woman, you might be a bit delluding yourself about the whole “confidence” thing.

    1. Well… that’s like 1,5% of the total amount of hair on her head. I’m not sure if I can call that as any success. It could have happened on its own.

  18. @Hlscc

    I have been consistently saying let’s pool together and get as much info as possible i. Terms of Brotzu lotion.. Most guys are stuck on bombarding Fidia with emails. Im sure if someone was able to catch up with Dr. Brotzu for for follow up it would work out better. He is supposed to speak in November at Fidia press conference. This sounds promising because that would only indicate that they had success witb AGA and he will be informing on the science behind and they will give a release date

    1. Hey Arianit it was posted a few times in the comments in recent posts. Will mention it in my next “brief items of interest” post.

    2. saw this too, seems actually pretty cool and if it works out would be amazing. Banking on this type of treatment or Tsuji now for a potential “cure”. Nothing else seems like a cure, just potential treatments.

    1. im from Spain dude, they just ‘transplant’ the stem cell we have in the follicle, leaving the follicle in the same place, so you dont loss the donor area, and you get new hair (from each cell group ) in the bald area, so they’re close to the 100% donor area recovery.
      But to be honest, it’s sound weird.. i need to see to believe.

      1. This kind of 80% regrowth claim looks familiar, especially for those who are following all latest hairtransplant options.

  19. Question for the ones who say JAK wont work.

    If brotzu lotion proves it works for AA and AGA, which have different mechanics, why couldnt JAK for both types of hairloss as well?

    1. As a layman I don’t have the answer but I don’t think AA and AGA cures have to be mutually exclusive. The underlying cause might be different but they both end up shrinking the hair follicle. Two separate chains with a similar (or the same) outcome. If you can break the final link in the chain (like Brotzu/Fidia claim), hypothetically you could have one cure for both AGA and AA.

    2. It seems both AA and AGA have an immune system component to it. At least that is how I look at it.

      AA looks like an immediate shock to the hair follicles caused by the immune system. It hits like a hurricane. AGA is more like a long-run attack of the immune system. You may call it life-long torture as it slowly progresses.

      However, there are probably several types of AA and several types of AGA.
      Some AA sufferers grow their hair back automatically, others need help via JAK inhibitors for instance.

      There are probably also different sorts of AGA. Just like Admin already indicated. Some have a larger role for their immune system in AGA than others.

  20. @ Imho I agree …similar to seti principal…

    I have heard rumors that kane has caught wind of Fidia and believes it would be worth it to start making lotion.. Haven’t confirmed this yet though.

  21. Hi Admin… Have you heard about Yeditepe University Hair Growth Cream? There is a great article on it on Follicle thought.

  22. I have androgenetic alopecia and I have used ruxolitinib cream for 4 days.after this period of time I saw some small black points on my head that I think they are new hair.unfortunately I only had 8 cc of ruxolitinib cream enough for 4 days….but I think it will cure us

      1. I cut my hair before using ruxo.about o.5 cm.after 4 days of using i saw many small black points but i am not sure if they have been on my head before ruxo or they are new

      2. I am female and I have hairloss from all of my head not bald areas,and these points are between existing hair,sorry for not knowing english well

        1. Thank you for reply. My English is bad too, I speak french usually. … You say: «I think you can buy 30 gr of ruxo in america about 1400$ and tofa is cheaper».

          We need a prescription from a doctor? Or can we get Ruxo internet. Is that I’m in Quebec (Canada) and it would be easier online. Do you have a web link to give me so that I place an order? Do you know the pharmacy / company name? How did you make cream? You did it yourself or it is sold as a cream 30gr 8 cc, … ?

          8cc = ???

          Thank you again!

          1. There are many websites that sell ruxo and tofa material but they only sell to companies and doctors for labratory experiments,so a doctor or a company should buy it for you,but I am not sure about the ready cream in drugstores,a professor in another country bought ruxo material for me(50 mgr 280$.it was american and more expensive than chinese or indian ruxo)and he posted for me and here another doctor made the cream for me,but the problem is that ruxo material or cream both should be in -20 temprature

          2. Dear william sometimes ago I spoke with a young boy from france and he told me that he has taken xeljanx tablets for 3 months and it has cured his androgenetic alopecia,I’m sure we will be cured through next two or three years,good luck my dear friend

            1. But I have not a AGA. I have a total alopecia medicinal diffuse. I took Prozac, Risperidone and Concerta at very very very high doses between 1999 and march 2014). Fall, itching, miniaturization never ceased… I lost 99,98% of my hair and the fall continues. My baldness is total (across the scalp). I’m not on the scale of Norwoods. I do not have small crowns behind the head as the Norwoods 6 or 7. Those with DUPA are in the same boat as me. It’s a nightmare.

              I cross my fingers for this to be effective for me too…

              p.s. I’m Quebecker in Québec (Canada), not French (France). 😉

              Thank you again!

          1. My friend bought it for me,I dont know the website,every day you need 2 cc,1 cc in morning and one in night,like minoxidil,mine was not cream,it was liquid,needed 60cc each month

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