Previous blogs of mine have discussed ruxolitinib and tofacitinib as treatment options for patients with advanced alopecia areata. Two new studies published recently in the journal JCI Insight support their benefits
1) Mackay-WIggans reported results of an open label trial of 12 patients with moderate to severe alopecia areata using oral ruxolitinib at a dose of 20 mg twice daily for 3-6 months followed by 3 months off the drug. 9 of 12 patients reported growth with no serious adverse events.
2) Researchers from Yale and Columbia University reported results of a study of 66 patients with advanced alopecia areata (including totalis and universalis). Patients received tofacitinib 5 mg twice daily for three months. Patients with alopecia totalis and universalis were less responsive than patients with alopeci areata but overall about one-third of patients experienced significant improvement. What was also very important to note was patients relapsed very quickly when the medication was stopped – losing hair within 8.5 weeks of stopping.
Comment: These JAK inhibitors continue to show evidence of being helpful for patients with advanced alopecia areata. We have been using tofacitinib for some time now and it's clear that in advanced alopecia areata it offers the potential to help a lot. The study I mentioned second reminds us that these are not cures and that patients lose hair when the treatment is stopped.
Mackay-Wiggan J et al. Oral ruxolitinib induces hair growth in patients witih moderate-to-severe alopecia areata. JCI Insight 2016
Kennedy Crispin M et al. Safety and efficacy of the JAK inhibitor tofacitinib citrate in patients with alopecia areata. JCI Insight 2016.
Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Vancouver office at 604.283.9299