Category Archives: JAK Inhibitors

Cancer Drug Ruxolitinib Reverses Alopecia Areata

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). 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, something that was not completely understood before.

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:

Video from Columbia University:

Just as I said two months ago when the tofactinib results came out, these results are yet gain unproven to work on the majority of balding people (who suffer from androgenic alopecia rather than alopecia areata). However, no decisive study as yet has been undertaken that examines the impact of  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 in my opinion) 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.”

Arthritis Drug Reverses Alopecia Universalis

On this blog, I primarily focus on androgenic alopecia, which is also known as male pattern baldness (MPB).  This kind of baldness results from male hormones (in particular, the derivative dihydrotestosterone, aka DHT) and an individual’s scalp hair follicles’ genetic susceptibility to miniaturization when under the influence of DHT.  The vast majority of men who suffer from hair loss are experiencing androgenic alopecia.

Alopecia Areata, Totalis and Universalis

A less common form of hair loss is called alopecia areata in which hair is lost from some areas of the body in small clumps.  More severe forms of alopecia areata include alopecia totalis (when hair is lost from the whole scalp) and alopecia universalis (when hair is lost from all over the body, including the scalp). One typical aspect of alopecia areata is something called exclamation point hair. This is where hairs are shaped like exclamation marks.

Tofacitinib

Today, it was announced that Yale scientists had cured alopecia universalis on a man via just administering an existing FDA-approved rheumatoid arthritis drug called tofacitinib citrate (brand name Xeljanz, manufactured by Pfizer).  The photos they presented are quite extraordinary (also see study link at the end of this post):

Edit: Photo was removed from linked site.

Source: The Society for Investigative Dermatology and Yale University.  Before and 8 months after photos.

Besides curing this person’s hair loss, the drug also significantly improved his psoriasis. Dr. Brett King and his wife Dr. Brittany Craiglow (the two scientists leading this experiment), credited Dr. Angela Christiano‘s earlier work (in which tofacitinib as well as ruxolitinib reversed alopecia areata in mice) as inspiring them to try this experiment in one of their human patients.  They now hope to start larger clinical trials.

I believe that there could also be an autoimmune inflammatory process involved with androgenic alopecia (just as with alopecia areata and psoriasis).  A large proportion of men suffering from androgenic alopecia complain about scalp itching, dryness, dandruff and psoriasis type symptoms.  Many find Nizoral Anti-Dandruff Shampoo to be particularly effective at dealing with this inflammation.  It would be quite something if tofacitinib also helped people like us who are suffering from androgenic alopecia.

The full article titled “Killing Two Birds with One Stone: Oral Tofacitinib Reverses Alopecia Universalis in a Patient with Plaque Psoriasis” is currently available online.

Update: CNN also now published this story, with a word of caution from George Cotsarelis regarding the side effects of tofacitinib, his opinion that there is no immune system component to androgenic alopecia, as well as more details about the actual patient (see photo below).

Kyle Rhodes had a full head of hair after eight months when he began using an arthritis drug to treat his alopecia areata.

Update: Interesting update from Australian newspaper where Dr. King says he is getting 200-300 e-mails a day about this.