JAK Inhibitors May Be First Effective Treatment for People with Alopecia Areata

Sep 28, 2016

Findings from two separate studies on the effectiveness of Janus kinase inhibitors in alopecia areata were recently published in the Journal of Clinical Investigation/Insight. The first one is an open-label clinical trial of 12 patients with alopecia areata from Columbia University, alongside a paper reporting results of a separate study from Stanford and Yale University that tested a similar drug.

Janus kinase inhibitors, more commonly known as JAK inhibitors, are a type of drug which suppresses the functionality of JAK enzymes within the body. Two such JAK inhibitors already approved by the U.S. FDA are ruxolitinib, a medication that is used to treat bone marrow malignancies, and tofacitinib, a treatment for rheumatoid arthritis. 

Seventy-five percent of patients with moderate to severe alopecia areata had significant hair regrowth after treatment with ruxolitinib, reported researchers from Columbia University Medical Center (CUMC). Nine of twelve patients demonstrated a remarkable response, exhibiting hair regrowth of 50 percent or greater throughout the treatment. 

In the Stanford/Yale study, a series of 66 patients with moderate to severe alopecia areata responded to another JAK inhibitor called tofacitinib. After three months of treatment, one-third of patients experienced more than 50 percent hair regrowth. 

Together, the two studies provide hope that JAK inhibitors may someday constitute the first effective treatment for alopecia areata. In addition, the lack of serious adverse effects in both studies is very reassuring.

While these results are encouraging, and are the largest studies involving JAK inhibitors to date, we wish to remind the alopecia areata community that these are preliminary studies in small populations. Larger, more robust clinical trials are necessary to fully evaluate safety, efficacy and durability. JAK inhibitors as a class of drugs are potent immunosuppressive agents, and in patients with underlying diseases, have been associated with significant side effects.

Sources: 

Mackay-Wiggan J, Jabbari A, Nguyen N, et al. Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata. Journal of Clinical Investigation/Insight. 2016.

Kennedy Crispin M, Ko JM, Craiglow BG, et al. Safety and efficacy of the JAK inhibitor tofacitinib citrate in patients with alopecia areata. Journal of Clinical Investigation/Insight. 2016.

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