With a once-a-day pill, patients with substantial hair loss may see hair regrowth within months.
Alopecia areata is an autoimmune condition that interferes with the bodys ability to grow hair.
People think, Im sure its terrible for teenagers.
Verywell Health / Design by Amelia Manley / Getty Images
Ill tell you, it is terrible at all ages.
I have patients who are in their 70s who are in tears about their alopecia areata.
Its really important that we have safe and effective treatments for our patients.
In clinical trials, one in three patients with severe alopecia who took the drug daily saw hair regrowth.
It opens a new era for alopecia, Guttman said.
I have many patients who really gave up at some point because there was nothing there.
Its a hopeful message for patients.
Baricitinib works by inhibiting a group of enzymes calledJanus kinase (JAK) inhibitors.
In 2018, the FDA approved baricitinib for rheumatoid arthritis.
Last month, the drug was alsoapprovedto treat adults who are hospitalized for COVID-19.
Some patients with alopecia may lose all their hair.
Regaining even three-quarters of their hair, Piliang said, feels like a success.
To be effective at spurring hair regrowth, baricitinib must be taken every day.
In some studies, patients who stopped taking the drugs daily saw hair shedding.
They work only when you use themthey don’t cure the disease, Piliang said.
Once you start, youre signing up to continue taking this medication long-term.
The drug can affect the liver or kidney.
And because its an immune suppressant, people who use it can be at a higher risk for infections.
From that research, JAKs inhibitors stood out as the most promising treatments, Piliang said.
Health providers have prescribed JAKs inhibitors, including baricitinib, off-label for years.
Olumiant has alist priceof $2,500 per month.
The FDA has only approved the drug for people with severe alopecia.
But people who have more limited disease might benefit from it, too, Guttman said.
The earlier that an alopecia patient receives treatment, the more likely they are to have sustained hair regrowth.
Whats mild to moderate today may be moderate to severe tomorrow.
You cannot tell with this diseaseits unpredictable, Guttman said.
There are other, non-systemic treatments for alopecia, such as injectable steroids and topical medications.
But these options come with side effects and can be challenging to administer.
Guttman said there are other JAK inhibitors in the pipeline for FDA evaluation.
If approved, these drugs could increase the number of options for patients with moderate to severe alopecia.
But we are not there yet, Guttman said.
What This Means For You
Baricitinib is already available in pharmacies.
2020;21(14):5137. doi:10.3390/ijms21145137
