Category Archives: JAK Inhibitors

Alopecia Areata, Angela Christiano, JAK Inhibitors

Alopecia Areata and Dr. Angela Christiano

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Despite the main focus of this blog being on androgenetic alopecia (AGA), I have made a number of posts about alopecia areata (AA) during the past year. Note that alopecia areata can be in the form of alopecia totalis or alopecia universalis.

Over 95 percent of hair loss patients suffer from AGA, also known as male pattern baldness and female pattern hair loss.

Alopecia Areata Treatment Breakthroughs

Over the past year, a lot of good news has come out regarding alopecia areata treatments involving JAK inhibitors. This is due to the great work of people such as Dr. Angela Christiano and Dr. Brett King.

Alopecia Areata Hair Loss Photo
Alopecia Areata hair loss patient from Dr. Christiano’s presentation.

In my opinion, there is also a chance that these JAK inhibitor drugs may benefit people with certain types of androgenetic alopecia. In particular, when there is an inflammatory (dandruff, itching, scaling) component involved too. However, this is pure conjecture on my part and entirely unproven.

Dr. Angela Christiano Video

Dr. Angela Christiano recently published a good video on alopecia areata, and it includes her personal experiences with the disease. There is more of a female focus in Dr. Christiano and her Columbia University team’s latest research, which is a rarity in the hair loss world.

This video is embedded below.  A few of the more interesting sections include:

  • 11:00 = I was quite surprised to read that alopecia areata affects 5.3 million people in the US, with a 1.7 percent lifetime risk.
  • 11:42 = comparison with genes involved in psoriosis and vitiligo.
  • 12:15 and 12:45 = most important part of the presentation related to research on Janus kinase (JAK) inhibitors. These include Ruxolitinib (JAK 1,2); Tofacitinib (JAK 1,2,3); Baricitinib (JAK 1,2); VX-509 (JAK 1,2); and R348 (JAK 1,2). The last three mentioned are not yet approved, while the first two are FDA approved for certain applications. You can read more about those drugs via the “Categories” section in the left hand column of this blog.
  • 12:57 = Results on mice.
  • 23:47 = Great results on a woman and later on a man.

Ruxolitinib, Alopecia Areata, Angela Christiano, Brett King, JAK Inhibitors, Raphael Clynes

Cancer Drug Ruxolitinib Reverses Alopecia Areata

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For the second time in just two months, the global media has gone beserk over photos that show complete reversal of alopecia areata. This time via ruxolitinib. The first time was two months ago in one of Dr. Brett King’s patients via the rheumatoid arthritis drug tofacitinib.

Ruxolitinib and Alopecia Areata

This time, it is via the bone marrow cancer drug ruxolitinib (approved for sale in the US and EU under brand names Jakafi and Jakavi). It seems like ruxolitinib can cure hair loss in some people suffering from alopecia areata.

These current results are even more significant because:

  1. They occurred in three patients rather than just one.
  2. The research and findings were conducted by the renowned hair loss research expert Dr. Angela Christiano and her team (in particular, Dr. Raphael Clynes) at Columbia University. In 2013, Dr. Christiano had already presented findings that both tofactinib and ruxolitinib reversed alopecia areata in mice. Moreover, these two doctors already filed a patent related to JAK 3 inhibitors in 2012 and are bonafide experts in this field.
  3. These new findings also determine the cellular mechanism (certain set of T cells attack hair follicles) that causes hair loss in people with alopecia areata. This was something that was not completely understood in the past.

The current findings were released in the online edition of Nature Medicine yesterday. All three patients saw excellent results within 4-5 months after taking the twice a day pill, and no adverse side effects were reported.

One of the patient’s images released by Columbia University:

Ruxolitinib Alopecia Areata
Ruxolitinib regrows hair in Alopecia Areata patient.

Video from Columbia University:

JAK Inhibitors

Just as I clarified two months ago when the tofactinib results came out, these results are yet gain unproven to work on the majority of balding people. This is because over 95 percent of hair loss is caused by a hormone driven condition called androgenic alopecia, rather than this less common alopecia areata problem.

However, no decisive study has yet been undertaken that examines the impact of JAK inhibitors such as tofactinib or ruxolitinb on people with androgenic alopecia. So the case is far from closed. I think that there is a good chance of there being an inflammatory immune system attack component to androgenic alopecia for many people, especially those who have significant itching and dandruff associated with their hair loss.

These drugs are expensive, and potential side effects are far more serious than with a drug such as Propecia. So doctors are reluctant to conduct these studies for what they feel is a cosmetic problem. However it is only a matter of time (probably months rather than years) before small-scale studies will be undertaken on all balding people.

Partly due to this development, Mark Blake of The Trichological Society of the UK said the following yesterday:

“It is a matter of time before we find a cure for male pattern baldness as well as alopecia. We know so much more about hair today and how it grows. We would like to think a cure could come within five years, definitely 10.”