JAK Inhibitors in Dermatology: The Promise of a New Drug Class

January 2017 in “ Journal of the American Academy of Dermatology ”

William Damsky, Brett King

JAK inhibitors tofacitinib ruxolitinib baricitinib alopecia areata hair regrowth topical administration oral administration

TLDR JAK inhibitors show promise for treating skin conditions like eczema, hair loss, and psoriasis.

JAK inhibitors, such as tofacitinib, ruxolitinib, and baricitinib, showed significant promise in treating various inflammatory skin conditions, including alopecia areata, atopic dermatitis, psoriasis, and vitiligo. These drugs demonstrated efficacy in promoting hair regrowth, reducing symptoms, and achieving substantial clinical improvements in patients who had not responded to other treatments. Safety concerns included risks of infection, cytopenias, and potential malignancy, but these were generally manageable. The versatility of JAK inhibitors, with both oral and topical administration options, suggested a promising future for this drug class in dermatology, with ongoing clinical trials further exploring their potential.

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Research cited in this study

17 / 17 results

research Tofacitinib for the Treatment of Alopecia Areata and Variants in Adolescents

139 citations, November 2016 in “Journal of the American Academy of Dermatology”

Tofacitinib helped regrow hair in most adolescents with alopecia areata, but more research is needed.

research Tofacitinib for the Treatment of Severe Alopecia Areata and Variants: A Study of 90 Patients

238 citations, November 2016 in “Journal of The American Academy of Dermatology”

Tofacitinib is effective and safe for severe hair loss, but full regrowth is less likely after 10 years of hair loss.

research Safety and Efficacy of the JAK Inhibitor Tofacitinib Citrate in Patients with Alopecia Areata

222 citations, September 2016 in “JCI insight”

Tofacitinib is safe and effective for severe alopecia areata, but hair loss may return 2 months after stopping treatment.

research Oral Ruxolitinib Induces Hair Regrowth in Patients with Moderate-to-Severe Alopecia Areata

196 citations, September 2016 in “JCI insight”

Ruxolitinib effectively regrows hair in most patients with severe hair loss.

$Successful Treatment of Refractory Alopecia Areata Universalis and Psoriatic Arthritis, But Not Plaque Psoriasis with Tofacitinib in a Young Woman$

research Successful Treatment of Refractory Alopecia Areata Universalis and Psoriatic Arthritis, But Not Plaque Psoriasis with Tofacitinib in a Young Woman

24 citations, June 2016 in “Acta dermato-venereologica”

Tofacitinib helped a young woman's severe hair loss and arthritis but not her plaque psoriasis.

research Efficacy of Tofacitinib in Treatment of Alopecia Universalis in Two Patients

51 citations, June 2016 in “Journal of the European Academy of Dermatology and Venereology”

Tofacitinib was effective in treating hair loss in two patients with alopecia universalis.

research Treatment of an Alopecia Areata Patient with Tofacitinib Results in Regrowth of Hair and Changes in Serum and Skin Biomarkers

70 citations, April 2016 in “Experimental Dermatology”

A patient with alopecia areata regrew hair after taking tofacitinib and showed changes in certain blood and skin markers.

research Transient Efficacy of Tofacitinib in Alopecia Areata Universalis

39 citations, April 2016 in “Case Reports in Dermatology”

Tofacitinib temporarily regrew hair in a man with alopecia, but its effects didn't last.

research Alopecia Areata: Animal Models Illuminate Autoimmune Pathogenesis and Novel Immunotherapeutic Strategies

82 citations, March 2016 in “Autoimmunity reviews”

Animal models have helped understand hair loss from alopecia areata and find new treatments.

research Profile of Tofacitinib Citrate and Its Potential in the Treatment of Moderate-to-Severe Chronic Plaque Psoriasis

37 citations, January 2016 in “Drug design, development and therapy”

Tofacitinib citrate is effective for moderate-to-severe chronic plaque psoriasis but has safety concerns at higher doses.

research Rapid Skin Repigmentation on Oral Ruxolitinib in a Patient with Coexistent Vitiligo and Alopecia Areata

157 citations, December 2015 in “Journal of the American Academy of Dermatology”

A man with vitiligo and alopecia saw quick skin and hair improvement with ruxolitinib, but skin color gains were lost after stopping treatment.

research Topical Ruxolitinib for the Treatment of Alopecia Universalis

96 citations, December 2015 in “JAMA dermatology”

Topical Ruxolitinib may safely treat severe hair loss.

research Tofacitinib Citrate for the Treatment of Nail Dystrophy Associated with Alopecia Universalis

41 citations, December 2015 in “JAMA Dermatology”

Tofacitinib citrate improved nail dystrophy and pain in patients with alopecia universalis without causing side effects.

research Reversal of Alopecia Areata Following Treatment With the JAK1/2 Inhibitor Baricitinib

184 citations, February 2015 in “EBioMedicine”

A patient with Alopecia Areata had complete hair regrowth after using the drug baricitinib.

research Alopecia Areata Is Driven by Cytotoxic T Lymphocytes and Is Reversed by JAK Inhibition

701 citations, August 2014 in “Nature medicine”

Alopecia areata can be reversed by JAK inhibitors, promoting hair regrowth.

research Killing Two Birds with One Stone: Oral Tofacitinib Reverses Alopecia Universalis in a Patient with Plaque Psoriasis

185 citations, June 2014 in “Journal of Investigative Dermatology”

A man with severe hair loss and skin disease regrew his hair with no side effects after taking tofacitinib.

research Familial Aggregation of Alopecia Areata

295 citations, January 2006 in “Journal of the American Academy of Dermatology”

Alopecia areata, a common autoimmune hair loss condition, often runs in families.

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community What else is good. Besides the big 3.

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Key treatments for hair preservation include minoxidil, finasteride/dutasteride, and microneedling, with additional options like specific shampoos, oils, biotin, zinc, tretinoin, clascoterone, and low-level laser therapy. Maintaining a healthy lifestyle, reducing stress, and addressing nutrient deficiencies can also support hair health.

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The treatment for androgenetic alopecia involves using finasteride and minoxidil with intense exercise and cold exposure to boost metabolism and reduce androgenic effects, potentially leading to hair regrowth. This approach may activate biological pathways for improved hair and overall health.

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7 upvotes 8 years ago

A woman who has been experiencing hair loss for several years, and her question of whether there is any benefit to getting a biopsy to check if it's AGA or diffuse alopecia areata when no cure or very effective treatment exists. Treatments such as spironolactone and Minoxidil/finasteride/RU58841 have previously been discussed.

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A 20-year-old user experienced worsening hair loss despite using various treatments including topical and oral minoxidil, finasteride, and dutasteride. Other users suggested additional treatments like JAK inhibitors, RU58841, and lifestyle changes, but the user remains skeptical and frustrated.

community The Worst Hair Loss Condition You (MAY) have: LPP

in Research/Science 43 upvotes 5 months ago

Lichen Planopilaris (LPP) is an autoimmune condition causing permanent hair loss and fibrosis, often misdiagnosed. Treatments include pioglitazone, topical corticosteroids, anti-inflammatory medication, and Jak inhibitors.

community I am a dermatologist with a clinical interest in alopecia. AMA

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In this conversation, 4990 discussed various treatments for hair loss, including oral minoxidil, PRP, transplan, Jak inhibitors, Dutasteride, Finasteride, Olumiant, Ketoconazole, RU58841, microneedling, baricitinib, and CCCA. They recommended scalp biopsies in unclear cases of DUPA, twice weekly to twice daily shampooing for topical minoxidil users, and two sessions spaced one month apart with follow up at month three to determine the effectiveness of PRP treatment.

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research The Efficacy and Safety of JAK Inhibitors for Alopecia Areata: A Systematic Review and Meta-Analysis of Prospective Studies

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Oral JAK inhibitors are effective and safe for treating alopecia areata but may need ongoing use to keep results.