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Drug Restores Hair in Some With Alopecia: FAQ

By Rita Rubin
WebMD Health News

Aug. 19, 2014-- A drug used to treat a rare bone marrow cancer caused hair to grow back in some people with alopecia areata, an autoimmune disease that attacks the hair follicles, scientists have found.

A small study shows that the drug, ruxolitinib, was effective in mice and in three people with the disease. Alopecia areata is thought to affect between 4 million and 5 million Americans, can strike at any age, and affects men and women equally. They are generally otherwise healthy. But they lose patches of hair and, in rare cases, all of their body hair.

This is the second report this summer about a drug causing hair to regrow in someone with alopecia. In June, the Journal of Investigative Dermatology published a report online from Yale University researchers regarding a man with almost no hair on his body. He grew a full head of hair, including eyebrows and eyelashes, after taking the drug tofacitinib for 8 months. Tofacitinib was approved in 2012 for the treatment of rheumatoid arthritis and belongs to the same class of drugs as ruxolitinib.

The two scientists who led the new study are Raphael Clynes, MD, PhD, who recently left Columbia University Medical Center to work for Bristol-Myers Squibb, and Angela Christiano, PhD, a professor in the departments of dermatology and of genetics and development at Columbia. Here, they discuss their research, which appears online in Nature Medicine.

Q. Why would you think to use a cancer drug to treat alopecia?

A. Christiano's past research suggested that in people with alopecia, hair follicles send out a false "danger signal" that triggers the immune system to attack them. Further research, which she and Clynes describe in their new report, identifies one way to stop the attack: a new class of drugs known as JAK inhibitors. Ruxolitinib, approved in 2011 to treat the bone marrow cancer myelofibrosis, is one such drug, along with tofacitinib, which Christiano and Clynes found to be effective in treating mice with alopecia.

Q. How many people with alopecia have been treated with ruxolitinib?

A. Clynes and Christiano have treated a total of a dozen, the first three of whom are included in the new study. After 5 months of treatment, all three regrew more than half of the hair they had lost.

“They were very pleased and happy,” Clynes says. Of the next six patients, though, only three regrew that much hair, he says. The last three haven’t been treated long enough to reach any conclusions.

Q. If ruxolitinib and tofacitinib promote hair growth in people with alopecia, could they be used to treat run-of-the mill male-pattern baldness?

A. “It’s not obvious at this point,” Christiano says. She's  looking into that question, though.

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