A drug commonly used for arthritis may be an effective way to reverse alopecia universalis, a condition that results in loss of all body hair.
There is currently no cure or long-term treatment for the condition. A new study, published online June 18 in the Journal of Investigative Dermatology, is the first reported case of successful targeted treatment.
A 25-year-old patient had previously been diagnosed with both alopecia universalis and plaque psoriasis, a condition characterized by scaly red areas of skin.The only hair on his body was within the psoriasis plaques on his head.
He was referred to dermatologists at Yale University for treatment of the psoriasis. The alopecia universalis had never been treated.
Doctors believed it might be possible to address both diseases simultaneously using an existing FDA-approved drug for rheumatoid arthritis called tofacitinib citrate.
The drug had been used successfully for treating psoriasis in humans. It had also reversed alopecia areata, a less extreme form of alopecia, in mice.
Full head of hair
After two months on tofacitinib at 10 mg daily, the patient’s psoriasis showed some improvement, and the man had grown scalp and facial hair—the first hair he’d grown there in seven years.
After three more months of therapy at 15 mg daily, the patient had completely regrown scalp hair and also had clearly visible eyebrows, eyelashes, and facial hair, as well as armpit and other hair.
“The results are exactly what we hoped for,” says Brett A. King, assistant professor of dermatology and senior author of the paper.
“This is a huge step forward in the treatment of patients with this condition. While it’s one case, we anticipated the successful treatment of this man based on our current understanding of the disease and the drug. We believe the same results will be duplicated in other patients, and we plan to try.”
Turns off immune system attack
“There are no good options for long-term treatment of alopecia universalis,” King says. “The best available science suggested this might work, and it has.”
“By eight months there was full regrowth of hair,” says coauthor Brittany G. Craiglow. “The patient has reported feeling no side effects, and we’ve seen no lab test abnormalities, either.”
Tofacitinib appears to spur hair regrowth in a patient with alopecia universalis by turning off the immune system attack on hair follicles that is prompted by the disease. The drug helps in some, but not all, cases of psoriasis, and was mildly effective in this patient’s case.
King has submitted a proposal for a clinical trial involving a cream form of tofacitinib as a treatment for alopecia areata.
Source: Yale University