Arthritis Drug Tofacitinib Cures Vitiligo: Dr. Brett King

I was not planning to write a post so soon after my prior one, but a new development from today is very interesting and exciting.

Regular blog readers will agree that last year’s most exciting developments in the hair loss world were alopecia areata being cured in a few patients. This feat was achieved by arthritis drug tofacitinib, and then again by bone marrow cancer drug ruxolitinib.

Dr. Brett King from Yale University led the work with tofacitinib, and he was interviewed on the Bald Truth show shortly thereafter. Most people on hair loss forums have not been too optimistic about a cure for alopecia areata also working on patients suffering from androgenetic alopecia (aka male pattern baldness). However, in that interview, Dr. King seemed to imply that it was definitely a possibility.

Since that time, myself and numerous others have eagerly hoped that Dr. King would start testing tofacitinib on patients suffering from male pattern baldness. This is by far the most common form of hair loss in both men and women.

Tofacitinib Cures Vitiligo

Instead, today Dr. King shocked the dermatological world for a second time for a totally different reason. Apparently, tofacitinib citrate cured one of Dr. King’s 53 year old female patient’s vitiligo. This latter condition is a devastating skin disease (Michael Jackson supposedly suffered from it).

Tofacitinib Vitiligo Reversal
Tofacitinib Vitiligo Reversal. Source: JAMA Dermatology.

Tofacitinib is a JAK 1/3 inhibitor that was approved by the US FDA in 2012 for the treatment of rheumatoid arthritis. Below are the before and after images from Dr. King’s latest groundbreaking findings. The source of these images is the full study that can be found in JAMA Dermatology.

Quite a few media outlets have covered this study today, including the UK’s Telegraph and US based CBS News. Here’s to hoping that in 2016 (or sooner), Dr. King publishes yet one more study that finally shows tofacitinib also curing androgenetic alopecia. At least in some patients in which there is also an inflammatory component to the disease.

So far, all of Dr. King’s results from last year and this year suggest that tofacitinib does not lead to any kind of severe side effects when taken under doctor supervision. It should also be noted that Pfizer has filed for FDA approval to treat psoriasis with tofacitinib after successful phase 3 trials.  This is all very encouraging when it comes to the safety profile of this seemingly miraculous drug.

Finally, it seems like tofacitinib might also successfully convert white fat (bad) into brown fat (good).  An important study on this was published in 2014.

39 thoughts on “Arthritis Drug Tofacitinib Cures Vitiligo: Dr. Brett King”

  1. Admin, this is amazing.. Good f******* job with this post. I wish my dermatologist would prescribe me this, but from my own research it’s extremely expensive. If he ends up treating psoriasis, I think a lot of people will learn soon after that it regrows hair in people with “pattern baldness”. I recently lost a hell of a lot of my left hairline due to inflammation and my derm thinks I had an outbreak of seborrheic dermatitis/psoriasis. However, it is in a “pattern” so she thinks it coincides with my genetic predisposition. I really think this will help androgenetic alopecia and I hope as much as you that he takes it to mpb now!

  2. I wonder if a drug that cures vitiligo could also cure gray hair? Ive heard of another study showing that vitiligo treatment helped reverse gray hair too.

  3. Apparently about a year ago dr. Christiano was said to be testing it on male pattern baldness. Have heard anything since. Anyone????

  4. Does anyone know what is going with Histogen? I thought that they are during phase II, but their profile on trials.gov isn’t actualised.

    1. Last I heard was that they were conducting their phase 3 trial in Japan. Not entirely sure though.

  5. @Emperor alopecia – Phase 3? Wow, I didn’t hear such an information. So I can’t understand why they are so silent in comparison to Replicel company. But phase 3 may be skipped in Japan now, so why they won’t just commercialize it there?

  6. 1.

    Am J Pathol. 2006 Mar;168(3):748-56.
    Human scalp hair follicles are both a target and a source of prolactin, which serves as an autocrine and/or paracrine promoter of apoptosis-driven hair follicle regression.

    The prototypic pituitary hormone prolactin (PRL) exerts a wide variety of bioregulatory effects in mammals and is also found in extrapituitary sites, including murine skin. Here, we show by reverse transcriptase-polymerase chain reaction and immunohistology that, contrary to a previous report, human skin and normal human scalp hair follicles (HFs), in particular, express both PRL and PRL receptors (PRL-R) at the mRNA and protein level. PRL and PRL-R immunoreactivity can be detected in the epithelium of human anagen VI HFs, while the HF mesenchyme is negative. During the HF transformation from growth (anagen) to apoptosis-driven regression (catagen), PRL and PRL-R immunoreactivity appear up-regulated. Treatment of organ-cultured human scalp HFs with high-dose PRL (400 ng/ml) results in a significant inhibition of hair shaft elongation and premature catagen development, along with reduced proliferation and increased apoptosis of hair bulb keratinocytes (Ki-67/terminal dUTP nick-end labeling immunohistomorphometry). This shows that PRL receptors, expressed in HFs, are functional and that human skin and human scalp HFs are both direct targets and sources of PRL. Our data suggest that PRL acts as an autocrine hair growth modulator with catagen-promoting functions and that the hair growth-inhibitory effects of PRL demonstrated here may underlie the as yet ill-understood hair loss in patients with hyper-prolactinemia.

    2.

    Exploring the role of prolactin in psoriasis.

    Prolactin (PRL) is well recognised for its role(s) in mammary gland development and function. Moreover, its role in skin biology, including the potent regulation of human hair growth, is becoming clearer. Less widely appreciated, however, is the potential role of PRL in the pathobiology of psoriasis. While the relationship between PRL and psoriasis remains enigmatic, several recent publications on the PRL-psoriasis connection have demonstrated a reawakening of interest in this conundrum. We take the occasion of these reports to underscore the importance of dissecting the role(s) of PRL in the aetiopathology of psoriasis, not least since this may help to identify novel hormonal treatment strategies in its management.

    3.
    Prolactin receptor

    Prolactin receptors are present in skin and hair[30]. When prolactin binds to the receptor, it causes it to dimerize with another prolactin receptor. This results in the activation of Janus kinase 2, a tyrosine kinase that initiates the JAK-STAT pathway.

    4.
    Tofacitinib (trade names Xeljanz and Jakvinus, formerly tasocitinib,[1] CP-690550[2]) is a drug of the janus kinase (JAK) inhibitor class, discovered and developed by Pfizer.

  7. If they have already completed phase 2, then I wouldn’t be surprised if they are commercializing histogen and staying quiet while in the process till they release it. Again this is just wishful thinking

  8. As for this recent psoriasis drug, I don’t see it working for baldness. If it did , I am sure it will never get released due to hair transplant industry, Pharma blocking it to market. A one stop solution like this would be amazing and we’ll deserved for all of us suffering from hair loss but we all know how all these scientific breakthrough turn out. Disappointing

  9. Wait a second. Do you mean Tafocinitib HAS successfully treated someone with MPB?

    Also, I thought (like other poster said) that Dr. Christiano was testing it on MBP?

    It must not have worked since she has started a new company doing research to grow hair from cells.

    I am the one from six months ago who kept mentioning to the ADMIN that these New Type of Arthritis drugs should work with MPB IF used with Skin Perturbation.

  10. Could This Finally Be It????????

    Also mentioned that he should keep a header for research on these New Type of Arthritis Drugs with Skin Perturbation since I think this is the solution. Better if no skin perturbation is required.

    Although it seemed as if Beno from 1980’s worked when people got a severe skin burn.
    All is my opinion.

  11. Sorry for a third post but need to add the following.

    Injured skin becomes Inflamed. Again, I wonder if Skin Perturbation, that causes inflammation. and somehow the drug will then work to treat MPB?

    All is my opinion.

  12. I don’t not know how people who suffer androgenetic alopecia hasn’t demanded a decent treatment in the XXI century …. What a shame hair loss industry for patients of course….

    1. I agree, Paul. Not only does it make the body find different hormone pathways, it does not allow them to revert back to what they once were when we were healthy, but just losing hair. Hopefully setipiprant will stop hairloss so that we can get off of internal AA’s.

  13. Admin, serious question: what would you do with this blog if there isn’t any good new treatment till 2020? Histogen and Follica are dead, CB is 2021, Seti commercialization date is unknown, Replicel has constant delays, hair multiplication is a matter of 10 years or more. I try to remain optimistic, but sometimes I am really scared about the future. I can’t understand why we don’t have any reasonable treatment in XXI century for such a terrible problem. I’ve tried Fin – is pure poison for me.

  14. What is the price of tofacitinib citrate 15mg for 10 tablets? I am alopecia universalis sufferer and want to give a try.

    1. Please do not take such a medication without consulting an expert such as Dr. King! At this point in time, I am not sure if this medication will have really bad long-term side effects and it is worth waiting to see if the US FDA approves it for other uses first.

  15. Sage,

    Do your research Histogen and Replicel are not dead! I just talked to Replicel the other day with their PR and they told me market outlook of 2018.

  16. @replicel55
    Yes, I know that Replicel isn’t dead, but I said only about their constant delays. In the first plan, phase II should have been started this spring. Now they are talking about the ,,hope” to begin it before the end of this year. But when it comes to Histogen and Follica – there are no news about them. Replicel gives us constant info on facebook/twitter etc., but theses companies are completely silent. Now news is bad news, isn’t it?

  17. The replicel-like cure for vitiligo would be as if they take healthy skin cells and then injected in vitiligo patches? It should work?

  18. J Tissue Eng Regen Med. 2015 Jun 29. doi: 10.1002/term.2046. [Epub ahead of print]

    Wnt1a maintains characteristics of dermal papilla cells that induce mouse hair regeneration in a 3D preculture system.

    Dong L1, Hao H1, Liu J1, Tong C1, Ti D1, Chen D1, Chen L1, Li M2, Liu H1, Fu X1, Han W1.
    Author information

    Abstract
    Hair follicle morphogenesis and regeneration depend on intensive but well-orchestrated interactions between epithelial and mesenchymal components. Therefore, an alternative strategy to reproduce the process of epithelial-mesenchymal interaction in vitro could use a 3D system containing appropriate cell populations. The 3D air-liquid culture system for reproducibly generating hair follicles from dissociated epithelial and dermal papilla (DP) cells combined with a collagen-chitosan scaffold is described in this study. Wnt-CM was prepared from the supernatant of Wnt1a-expressing bone marrow mesenchymal stem cells (BM-MSCs) that maintain the hair-inducing gene expression of DP cells. The collagen-chitosan scaffold cells (CCS cells) were constructed using a two-step method by inoculating the Wnt-CM-treated DP cells and epidermal (EP) cells into the CCS. The cells in the air-liquid culture formed dermal condensates and a proliferative cell layer in vitro. The CCS cells were able to induce hairregeneration in nude mice. The results demonstrate that Wnt-CM can maintain the hair induction ability of DP cells in expansion cultures, and this approach can be used for large-scale preparation of CCS cells in vitro to treat hair loss.

    Copyright © 2015 John Wiley & Sons, Ltd.

    KEYWORDS:
    Wingless-type mouse mammary tumour virus integration site; bone marrow mesenchymal stem cell; conditioned medium; dermal papilla; hairfollicles; regeneration; three-dimensional; tissue engineering

  19. HAIR LOSS FORUMS: SHAME…in special the bald truth…always are delays and more delays….they are pathetic.

  20. Would you get a hair transplant now or hold of for replicel? Transplants are looking really good now days (but of course cost and waiting for growth sucks) . Wondering if in 5 years I’d regret it if replicel is what hope it is or will I look back and think I should have just got a transplant. This is a great website admin… Thank you for keeping us informed!

    1. I’m in the same boat. It’s a gamble to wait but at the same time it could pay dividends. I just see hair transplants as a temporary mask – rearrange the hair you have to make yourself appear less bald? It’s just smoke and mirrors. I agree with Admin and believe we’ll have something by 2020.

  21. @Lookingformylid: I don’t know what norwood phase you have, but remember that Replicel can’t bring suddenly nw6 to nw1. If I were you, I would wait for it to stop further hair loss + little regrowth (1-2 norwoods) and do HT (piloscopy, which be available within 1-2 years).

  22. What is the price of tofacitinib citrate 15mg for 10 tablets? I am vitiligo sufferer and want to give a try.

    Can I cure my vitiligo patches . that patches on my labow knees eyes lips.

    Your vitiligo cure treatment when will be available in India ?

  23. I am desperate for a cure to Vitiligo.

    Can you tell me the prescription details/schedule. I will be your 2nd patient.

  24. What is the price of tofacitinib citrate 15mg for 10 tablets? I am vitiligo sufferer and want to give a try.

    Can I cure my vitiligo patches . that patches on my labow knees eyes lips hands & leg last from 10 years. Can it curable ?

    Your vitiligo cure treatment when will be available in India?

    Please inform us.

  25. Is ANY country selling without prescription either a topical JAK-STAT or an oral form? Does not have to be Tofacitinib. Can be ANY JAK-STAT. I am tired of waiting. I have Vitiligo everywhere. So, please if you know a country or countries that sell this over the counter, please help me.

  26. HI I have vitiligo and would absolutely LOVE to have a cure for it, although not a physical painful disease it’s emotionally very hurtful!! So if this drug Tofacitinib is available I am willing to try it, please let me know how I can get some? Also I heard that Doctors in Cuba have a success rate of 70-80% success rate using the drug Melagenina Plus has anyone heard of that?

Leave a Reply to Rich Cancel reply

Your email address will not be published. Required fields are marked *