Dr. Ahmed Hair loss is a very common problem. It affects people of all ages. However, the causes and treatments of hair loss in different age groups vary.
Until now, hair transplants have been considered the last option for severe hair loss. However, novel biological medicines are getting approval by the FDA.
The latest among these biological treatments is an oral JAK inhibitor, Deuruxolitinib.
The FDA approved Deuruxolitinib for the treatment of severe alopecia areata which is refractory to standard therapy.
What is Alopecia Areata?
Alopecia Areata is a patchy hair loss, usually starting from a single patch of hair loss. The disease may progress to multiple patches and even complete hair loss may occur.
It commonly affects the scalp, but can also affect the beard, eyebrows, and limbs.
It is an autoimmune disorder and commonly associated with other autoimmune disorders such as:
- Atopic dermatitis (eczema)
- Vitiligo
- Thyroid disorders
- Autoimmune Rheumatic Diseases, and
- Psychiatric disorders such as depression and anxiety.
When hair loss affects the whole scalp, it is called Alopecia Totalis. When it involves the entire body, it is called Alopecia Universalis.
People with Alopecia Areata commonly have nail changes in the form of pitting, ridges, and Beau’s lines.
It is important to know that Alopecia Areata is different from male-pattern or female-pattern baldness, also called androgenic alopecia.
The male and female pattern of hair loss is the most common. It is often hereditary but is also affected by medical conditions such as thyroid disorders, hormonal changes, nutrient deficiencies, and stress.
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How is Alopecia Areata Treated?
Alopecia Areata is commonly treated with topical corticosteroids. Intradermal corticosteroids are considered the most effective.
Children and patients who can not tolerate intralesional corticosteroids may use topical corticosteroids, however, they are less effective than intradermal injections.
Topical 5% Minoxidil may help, especially during the early stages of the disease.
Other treatments include oral cyclosporin, tacrolimus, and methotrexate.
Patients may use camouflage to cover affected areas of their eyebrows.
Lastly, immunotherapy is considered the most effective treatment in patients intolerant to corticosteroids or those with refractory disease.
Among the medications approved in this category are Baricitinib (Olumiant) and Ritlecitinib (Litfulo).
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Breakthrough with FDA-Approved Deuruxolitinib:
On 25th July 2024, the FDA approved Deuruxolitinib, an oral JAK inhibitor for the treatment of refractory Alopecia Areata.
The approval was based on two phase 3 clinical trials, THRIVE-AA1 and THRIVE-AA2 which involved 1220 participants.
The study participants had an average of 13% scalp hair at the time of enrollment in the study.
After 24 weeks of Deuruxolitinib treatment, 30% of the study participants had 80% hair growth, 25% of which achieved near complete hair regrowth.
The drug was well-tolerated during the study. Only 3.1% of the participants had to discontinue it because of side effects.
The most common side effects reported were headaches and nasopharyngitis.
Deuruxolitinib is the 3rd among JAK Inhibitors to be approved for the treatment of Alopecia Areata.
The first JAK inhibitor, Baricitinib (Olumiant), was approved in 2022, followed by Ritlecitinib (Litfulo) in 2023 for the treatment of hair loss in patients with Alopecia Areata.
All three JAK inhibitors, Olumiant, Litfulo, and Deuruxolitinib are taken as oral tablets.
Deuruxolitinib is taken as 8 mg tablets orally two times a day for the treatment of alopecia areata.
Here is a downloadable poster of the THRIVE-AA1 study which was presented at the 2024 American Academy of Dermatology Annual Meeting
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In Conclusion:
Deuruxolitinib is the third JAK inhibitor to receive FDA approval for treating alopecia areata.
This development is particularly exciting because it expands the range of treatment options available to physicians and patients, allowing for more personalized and effective care.
Additionally, increased competition in the market often leads to more cost-effective treatments, as pharmaceutical companies may lower their prices to remain competitive.
