Category Archives: Baricitinib

Alopecia Areata, Baricitinib, JAK Inhibitors, Olumiant

Baricitinib (Olumiant) Approved by FDA for Alopecia Areata

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Around 90-95 percent of people with hair loss suffer from androgenetic alopecia (AGA), also known as male pattern baldness. Just 1-2 percent suffer from alopecia areata (AA), aka patchy hair loss due to an autoimmune problem.

However, in recent years, alopecia areata (and the related alopecia totalis and alopecia universalis) have been in the news almost every week. Most of the coverage tracks miraculous before and after hair growth results via the use of JAK inhibitors. I covered this subject close to ten times a few years ago. More than 300,000 Americans currently live with severe alopecia areata.

FDA Approves Baricitinib for Alopecia Areata

Yesterday, the US FDA approved Olumiant (baricitinib) oral tablets to treat adult patients with severe alopecia areata. This drug is sold by Eli Lilly and Incyte. This once-a-day pill is the first ever approved in-disease systemic treatment for adults with severe alopecia areata (AA). Monthly cost without insurance will be $2,500.

Olumiant is a Janus kinase (JAK) inhibitor that blocks the activity of a family of enzymes. This in turn interferes with the pathway that leads to inflammation in alopecia areata. Note that Olumiant is already approved for treating moderate and severe rheumatoid arthritis. It is available in 4 mg, 2 mg and 1 mg tablets (with the recommended dose for AA being 2 mg per day).

The approval for alopecia areata was based on Lilly’s BRAVE-AA1 and BRAVE-AA2 trials. These were the largest Phase 3 clinical trials ever completed in humans suffering from AA. Both trials were led by Yale University’s Dr. Brett King.

Patients in the Lilly study experienced relatively mild side effects, including slightly increased risk of acne, urinary tract infections and other infections. Those side effects were easily treatable or improved without treatment. Around one-half of patients regrew their hair after one year of treatment.

Baricitinib Hair Growth
Baricitinib Hair Growth in Alopecia Areata Patients. Before and After. Source: Dr. Brett King et al in the New England Journal of Medicine.

Note that it was Aclaris Therapeutics which originally got the patent rights for the use of baricitinib in treating hair loss in 2017. Earlier this year, I also discussed some phenomenal baricitinib hair growth results. The before and after photos (seen above) are courtesy of Dr. Brett King and his work.

JAK Inhibitors

A number of other JAK inhibitors have shown impressive results in treating alopecia totalis and universalis. Among the more famous of these include ruxolitinib, tofacitinib and decernotinib. See all my past posts covering JAK inhibitors for more details.

Pfizer (Ritlecitinib) and Concert Pharmaceuticals (CTP-543) are also planning to release JAK inhibitors to treat alopecia areata in the near future.

American Academy of Dermatology, Baricitinib

2022 AAD Annual Meeting

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— Yet another interesting conference will take place in Monaco from March 31-April 2 (h/t “Ben” yet again). It is the 20th edition of the Aesthetic & Anti-Aging Medicine World Congress.

Among the highlights (see full abstract here) will include:

  • An update from HairClone’s Dr. Paul Kemp.
  • Several presentations on exosomes for hair growth.
  • Several new reports of PRP reducing hair loss.
  • An interesting report form Dr. Pietro Gentile where he analyzes the benefits of hair follicle mesenchymal stem cell (HF-MSC) injections.
  • An update on ARTAS robotic hair transplants.

AAD 2022: Key Hair Loss Related Updates

— Update from AAD2022.

— Baricitinib JAK inhibitor leads to significant hair regrowth in Alopecia Areata patients. Dr. Brett King video. Amazing before and after photos, but we have seen similar results from other JAK inhibitors in the past.

Baricitinib Hair Growth
Baricitinib Hair Growth in Alopecia Areata Patients. Before and After. Source: Dr. Brett King et al in the New England Journal of Medicine.

— At AAD2022, Alma launched an ultrasound based laser system called Alma TED™. It benefits hair growth via improving blood flow. Also see my recent post on sound therapy for hair growth. Some before and after photos here.

— Update from the 2022 Oscars, where a hair loss issue leads to violence.

Introduction

American Academy of Dermatology (AAD) Logo

The 2022 American Academy of Dermatology (AAD) Annual Meeting will run from March 25, 2022-March 29, 2022 in Boston, Massachusetts. After being cancelled in 2020, this time it is an in-person event.

The AAD was founded in 1938 and currently counts most practicing dermatologists in the United States as members. In the past, I wrote about the 2016 AAD annual meeting and the 2018 AAD annual meeting. I also covered the lesser known Society for Investigative Dermatology (SID) conferences several times.

Make sure to follow on Twitter the AADmember account and the AADskin account for more information. #AAD2022.

2022 AAD Meeting Hair Loss Sessions

Unlike conferences focused solely on hair loss (e.g., WCHR, ISHRS, EHRS and AHRS), the AAD meetings include a wide range of dermatological conditions. Skin issues are of foremost importance.

Nevertheless, hair related sessions and posters (18 pages) are still numerous. The AAD hair loss sessions tend to focus more on existing treatments and recent developments and improvements in technology. You do not see much on long-term future developments.

Among the interesting presentations this time around include:

Disclosures and Corporate Affiliations

What I always find interesting in these conferences is the company affiliation disclosures. In some cases, hair loss product vendors provide fees to the presenters. In other cases, research funding and grants. And in other case, I assume just advisory support. Some of the “type of relationship” acronyms in the disclosure statements are not defined.

  • It is great to see Cassiopea so active. I still have hopes that Breezula will be at least as good as Minoxidil, while targeting an entirely different pathway.
  • Other hair loss companies that I have covered that are also mentioned as sponsors/funders/affiliates include AbbVie; Allergan; Almirall; Applied Biology; Follica and L’Oréal.
  • I find it interesting that low-level laser device manufacturers such as Capillus, HairMax LaserComb and Theradome are associated with so many of the researchers.
  • A number of smaller companies that I have discussed on this blog seem to be involved with a number of researchers. The most surprising of these is DS Laboratories.
  • The disclosure list of some of the scientists presenting is unbelievably lengthy. It is worth checking out Dr. Neil Saddick and Dr. Adelaide Hebert. Surprisingly, Dr. Ken Washenik only shows two companies (Cassiopea and Follica) in his disclosure list.