Q. When the people in the study stopped taking ruxolitinib, did their hair fall out again?
A. Scientists are continuing to check their hair growth every couple of months. It’s plausible that the drug could have a permanent effect, Clynes says. On the other hand, the drug might have only put the disease into remission, so it could eventually come back and cause hair loss.
Q. Wouldn’t it make more sense to rub the drug on the skin where you’d like to grow hair, rather than swallowing it in a pill?
A. “It would be wonderful to have both an oral and a topical” version of a drug that could cause hair to regrow in alopecia patients, Clynes says. But no topical form of ruxolitinib or tofacitinib has been approved for human use, so he and Christiano mixed up their own with ingredients from China and tested them on the mice, with excellent results.
Q. Since ruxolitinib is already on the market to treat that bone marrow cancer, couldn’t people with alopecia ask their doctor for a prescription?
A. Once the FDA approves a drug to treat one condition, doctors are free to prescribe for others, a practice called “off-label” use. But insurers generally cover medications only for their approved uses.
Jakafi, the brand name for ruxolitinib, costs $8,753 for a month’s supply, which amounts to more than $100,000 a year, says Pamela Murphy. She's vice president for investor relations and corporate communications at Incyte, the Wilmington, DE, company that markets the drug.
“I think that is a pretty high price point,” Clynes says. “Our hope is a year of therapy wouldn’t be required.” If a wealthy person with alopecia wanted to try the drug, he says, “I would not personally be uncomfortable prescribing the medicine if the patient was otherwise healthy and young and had an expected low-level risk of complications.”
Q. What’s the next step?
A. Clynes and Christiano are seeking funding to conduct a randomized trial comparing a JAK inhibitor -- besides ruxolitinib and tofacitinib -- with an inactive pill in people with alopecia.