Category Archives: JAK Inhibitors

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.”

Tofacitinib, Alopecia Areata, Alopecia Totalis, Alopecia Universalis, Brett King, JAK Inhibitors, Psoriasis, Yale University

Tofacitinib Reverses Alopecia Universalis Hair Loss

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On this blog, I primarily focus on androgenic alopecia (AGA), which is also known as male pattern baldness (MPB). This kind of baldness results from male hormones (in particular, dihydrotestosterone) and scalp hair follicle genetic susceptibility to miniaturization. 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).

Tofacitinib Cures Alopecia Universalis

Today, it was announced that Yale scientists led by Dr. Brett King had cured alopecia universalis in a man. They did this 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 the study link at the end of this post.

Tofacitinib reverses alopecia areata.
Tofacitinib reverses alopecia areata and universalis.

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

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 top rated dandruff shampoos 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 study 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. In his opinion, there is no immune system component to androgenic alopecia.