In what seems to be a happy accident, a drug commonly used to treat rheumatoid arthritis, tofacitinib, has helped a man with alopecia universalis regrow his hair. Over the course of eight months of treatment, the man has regrown a full head of hair, as well as eyebrows and other body hair.
The man was treated by two doctors at Yale University. The results from the treatment were published in the Journal of Investigative Dermatology in the middle of June.
Along with alopecia universalis, the 25-year-old man suffered from plaque psoriasis, which causes scaly red areas to form on the skin. In the case of the patient, the areas of psoriasis were the only areas on his body that had hair growth before treatment. One of his doctors, Dr. Brett King, believed that they could possibly treat both conditions with the same medication. Tofacitinib has been shown to help treat psoriasis in people. It’s also been shown to help reverse a different type of alopecia, alopecia areata, in mice.
Understanding Alopecia Universalis
Alopecia universalis is the rarest type of alopecia. It is an autoimmune disease that causes hair loss in all areas of the body, compared to the patchy hair loss commonly associated with alopecia areata. The immune system of people with alopecia universalis attacks the hair follicles, causing the hair to fall out.
There’s no cure for the condition, although some treatments, such as immunotherapy drugs or cortisone pills, have helped patients regrow hair. These treatments are usually prescribed off-label, meaning they aren’t specially designed or clinically proven to treat alopecia universalis.
In the case of medications like steroids, patients can only take them for short periods of time, as the risk for side effects is high. The results from off-label medications has so far not been impressive.
Surgical procedures such as hair restoration aren’t effective for alopecia, as the patients typically still has active inflammation that can kill transplanted hair follicles. In some cases, the patient sees a regrowth of hair on its own.
How the Drug Is Thought to Work
Dr. King decided to give the patient tofacitinib because he thought that it had the greatest chance of treating both the psoriasis and the alopecia. He referred to the work of Dr. Angela Christiano, a scientist at Columbia University, as an inspiration for using tofacitinib. Christiano conducted studies that examined the effects of the drug on mice with alopecia.
Tofacitinib is thought to work on alopecia because it shuts down the immune response that attacks the hair follicles. In the case of the single patient, it’s proven effective. Although that patient had no hair growth for seven years, two months into his treatment, taking 10 mg of the medicine daily, he started to have some hair growth on both his scalp and face.
The patient continued to take the medication for another three months. The increased dose of 15 mg daily led to complete regrowth of the hair on his scalp. He also had eyebrows, lashes, armpit hair and other body hair after five months. After eight months, the patient had a full head of hair. The patient didn’t report any side effects and lab tests showed no abnormalities.
What It Means for Patients
While the results of the study seem promising, it is still too soon to tell what the impact of tofacitinib will be on people with alopecia universalis. The medication was only given to a single patient, which isn’t a large enough sample for it to become a standard treatment option. But, further studies are possible and could expand the treatment horizons for the medication.
Dr. King and his fellow researchers have put in a proposal for a clinical trial. If accepted, the trial would examine the effectiveness of a cream form of the drug to treat alopecia areata.
Patients with alopecia may need to wait for an official treatment to become available. But, patients with other forms of hair loss, such as female or male pattern baldness, have proven treatment methods available to them, such as hair restoration surgery.
If you are suffering from hair loss, finding out the reason for it is the first step to figuring out the appropriate treatment. Dr. Jeffrey Epstein, a top hair transplant surgeon, can advise you on the best options for your hair loss. To learn more, contact his practice in New York City or Miami. Call (305) 666-1774 for an appointment at the Miami office or (212) 759-3484 to schedule an appointment at the New York office.
