Novel Investigational Drugs for Alopecia Areata and Future Perspectives

April 2024 in “ Expert opinion on investigational drugs ”

Ivana Chim, Ragini Ghiya, Rodney Sinclair, Samantha Eisman

alopecia areata Janus kinase inhibitors baricitinib ritlecitinib deuruxolitinib dupilumab IL-17 inhibitors IL-2 inhibitors apremilast minoxidil platelet-rich plasma AA JAK inhibitors PRP

TLDR JAK inhibitors are safe and effective for treating moderate-to-severe alopecia areata.

The article discusses the pathogenesis of alopecia areata (AA) and highlights recent advancements in its treatment, particularly focusing on three oral Janus kinase (JAK) inhibitors: baricitinib, ritlecitinib, and deuruxolitinib. Phase 3 randomized-control trials (RCTs) for these drugs have shown superior efficacy compared to placebo, with common side effects including headache, nasopharyngitis, acne, and upper respiratory tract infections. Other systemic JAK inhibitors and biologic agents like dupilumab have also shown some efficacy. However, topical JAK inhibitors and other treatments such as IL-17 inhibitors, IL-2 inhibitors, and apremilast lack robust evidence and are not recommended. Low-dose systemic minoxidil may enhance the effects of JAK inhibitors, improving hair regrowth and reducing relapses. The evidence for platelet-rich plasma (PRP) therapy in AA remains limited. The authors disclose various affiliations and financial involvements with pharmaceutical companies.

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Research cited in this study

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$Adjuvant Treatment with Oral Minoxidil for Refractory Alopecia Areata to JAK Inhibitors$

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Tofacitinib and oral minoxidil together effectively regrow hair in severe alopecia areata patients.

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