ATI-502 Topical JAK Inhibitor for Alopecia Areata Did Not Show Benefit
The JAK inhibitors are a group of medications that have been shown to benefit patients with alopecia areata when taking in the oral form. Tofacitinib, Ruxolitinib and Baricitinib are pills that have shown benefit in alopecia areata and are frequently used ‘off label’ in more advanced forms of the disease. By off label, we simply mean that the drugs have not yet received formal FDA or Health Canada approval.
There has been a massive surge in interest in studying whether topical JAK inhibitors could provide benefit. Companies such as Aclaris are studying various JAK inhibitors for alopecia areata. I was interested to note this week the final results that were published by Aclaris Therapeutrics regarding their Phase 2 clinical trial of ATI-502 (also known as AA-201) a ‘topical’ JAK inhibitor for alopecia areata. The study showed that the topical JAK inhibitor treatment did not prove more effective than the placebo.
The study was a double blinded placebo controlled trial which evaluated two concentrations of AT-502, namely 0.12 % and 0.46 %. Participants applied the treatment twice daily for 24 weeks.
These studies of topical JAK inhibitors are very important (and so are the studies with the oral JAK inhibitors). While it would seem that topical JAK inhibitors should help if the oral forms help, that needs to be proven in well conducted trials. The way that a topical JAK inhibitor is made up by the pharmacist is clearly important as previous studies showed the some formulations - like ointments - are quite ineffective for treating alopecia areata. For example, a 2018 study by Liu, Craiglow and King did not find the 2 % ointment to be all that helpful.
It will be interesting to see if other topical JAK inhibitors have positive results in ongoing studies.
Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Whistler office at 604.283.1887