The treatment, which was conducted at Yale University School of Medicine, involved a 25-year-old male who was left without hair as a result of this disease. After being treated with tofacitinib citrate, a drug for rheumatoid arthritis, the man grew eyebrows, eyelashes, facial, armpit, and other hair.
Dr. Brett A. King, assistant professor of dermatology at Yale University School of Medicine, and senior author of a paper, published in the Journal of Investigative Dermatology, said in a press statement, “The results are exactly what we hoped for. 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.”
In addition to alopecia universalis, the patient was also diagnosed with 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.
Drug Was Effective in Mice
King set out to address both diseases simultaneously using tofacitinib citrate, which had been used successfully for treating psoriasis in humans. Research conducted by Columbia University scientist Angela Christiano prompted King to try tofacitinib as a therapy in this patient with both alopecia universalis and psoriasis. Christiano's work showed that tofacitinib and a related medicine reverse alopecia areata in mice.
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, the authors said.
Commenting on the Yale study, Dr. Richard Mizugachi, assistant clinical professor of the Department of Dermatology, at Mount Sinai in New York, told Healthline, that he has prescribed the drug used in the Yale study, to two patients with alopecia. One of the patients had hair regrowth, although not as much as was seen in the patient in the Yale study. The second patient had side effects and couldn’t tolerate the drug.
“Alopecia is an autoimmune disease in which your body is attacking your hair. The drug blocks the pathway where it prevents your body from fighting the hair. The drug has had promising results in mice studies. It’s nice to see the same correlation occur in human studies. It is a medication that is going to revolutionize treatment for alopecia because a lot of things don’t work and they are also painful. We have to use needles and shots. If alopecia could be treated with pills, that’s a pretty bright future,” Mizugachi said.
Full Regrowth of Hair After Eight Months
After two months on 10 mg daily of tofacitinib, the patient’s psoriasis showed some improvement, and the man had grown scalp and facial hair. This is the first hair he had grown there in seven years. Following three more months of therapy at 15 mg daily, the patient had completely regrown scalp hair. He also had clearly visible eyebrows, eyelashes, and facial hair, as well as armpit and other hair, according to the doctors.
Study co-author Dr. Brittany G. Craiglow, said in the press statement, that by eight months the man had full regrowth of hair. The patient had no side effects and there were no test abnormalities, according to Craiglow.
Future Clinical Trial Will Use a Cream
“There are no good options for long-term treatment of alopecia universalis. The best available science suggested this might work, and it has,” said King, who has submitted a proposal for a clinical trial involving a cream form of tofacitinib as a treatment for alopecia areata.
King concluded, “This case highlights the interplay between advances in science and the treatment of disease, and it provides a compelling example of the ways in which an increasingly complex understanding of medicine, combined with ingenuity in treatment, benefits patients.”
Photo courtesy of Yale University