Right on the Head: JAK Inhibitors May Reverse Hair Loss

JAK inhibitors, used to treat blood and autoimmune disorders, also reverse one type of hair loss.
BY MARIJKE VROOMEN DURNING, RN
PUBLISHED: APRIL 15, 2017
There’s a reason the drugs work specifically in those with AA.

“In alopecia areata, the hair follicle sends out a message that calls the body’s immune system to attack the hair,” King explained. “When a patient takes a JAK inhibitor, this message to the immune system is interrupted, allowing the hair to grow. And because the hair follicle was not damaged, the hair grows as it should, as long as the patient takes the medication. This is unlike male- or female-pattern baldness, in which the hair follicle atrophies and stops growing hair. In that case, JAK inhibitors cannot help.”

In fact, unlike in AA, experts “don’t know exactly what causes male-pattern baldness or female-pattern baldness,” King continues. However, they do know of one strategy that has proved helpful for that condition over the past few years: Rogaine, a topical form of minoxidil, which is a blood pressure medication. In pattern baldness, he says, “Rogaine seems to rejuvenate some hair follicles.” Rogaine may also work for those with mild AA.

Both Rogaine and Xeljanz were found to have an effect on alopecia accidentally, as people taking the drugs experienced renewed hair growth. However, taking JAK inhibitors to treat alopecia would not be expected to confer any protections against cancer, as no studies have been done that demonstrate such an association, King says.

Besides Rogaine, more typical treatments for AA include steroids, the psoriasis medication Dritho-Scalp (anthralin), topical immunotherapy and photochemotherapy (which involves the patient taking a light-sensitive drug and then exposing the scalp to ultraviolet light).

EFFECTIVENESS OF JAK INHIBITORS

JAK inhibitors have been approved by the Food and Drug Administration (FDA) to treat people with blood and autoimmune diseases. In the cancer arena, Jakafi (ruxolitinib) is approved to treat myelofibrosis and polycythemia vera. Meanwhile, Xeljanz (tofacitinib) is approved to treat rheumatoid arthritis, and Apoquel (oclacitinib) to treat dermatitis and associated issues. Many other JAK inhibitors are being tested in clinical trials.

JAK inhibitors interfere with the body’s ability to generate enzymes called cytokines, which stimulate growth signaling pathways. If unchecked in polycythemia vera, for instance, these growth factors stimulate cells to grow and divide excessively in the bone marrow, causing blood to thicken, increase in volume and have problems flowing through vessels.

Recently, King and his colleagues published the results of studies that tested JAK inhibitors as treatments for AA.



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