Alopecia + Xeljanz

SDSue

Southeast
Messages
1,066
Likes
3,026
Location
Florida
In hairless man, arthritis drug spurs hair growth — lots of it
By Eric Gershon
June 19, 2014

(Illustration by Michael S. Helfenbein)

A man with almost no hair on his body has grown a full head of it after a novel treatment by doctors at Yale University.

There is currently no cure or long-term treatment for alopecia universalis, the disease that left the 25-year-old patient bare of hair. This is the first reported case of a successful targeted treatment for the rare, highly visible disease.

The patient has also grown eyebrows and eyelashes, as well as facial, armpit, and other hair, which he lacked at the time he sought help.

“The results are exactly what we hoped for,” said Dr. Brett A. King, assistant professor of dermatology at Yale University School of Medicine and senior author of a paper reporting the results online June 18 in the Journal of Investigative Dermatology. “This is a huge step forward in the treatment of patients with this condition. While it’s one case, we anticipated the successful treatment of this man based on our current understanding of the disease and the drug. We believe the same results will be duplicated in other patients, and we plan to try.”

The patient had previously been diagnosed with both alopecia universalis, a disease that results in loss of all body hair, and plaque psoriasis, a condition characterized by scaly red areas of skin. The only hair on his body was within the psoriasis plaques on his head. He was referred to Yale Dermatology for treatment of the psoriasis. The alopecia universalis had never been treated.

King believed it might be possible to address both diseases simultaneously using an existing FDA-approved drug for rheumatoid arthritis called tofacitinib citrate. The drug had been used successfully for treatingpsoriasis in humans. It had also reversed alopecia areata, a less extreme form of alopecia, in mice.

“There are no good options for long-term treatment of alopecia universalis,” said King, a clinician interested in the treatment of rare but devastating skin diseases. “The best available science suggested this might work, and it has.”




These panels show the patient's head a) before treatmen with tofacitinib, b) two months into treatment, c) five months into treatment, and d) eight months into treatment.

After two months on tofacitinib at 10 mg daily, the patient’s psoriasis showed some improvement, and the man had grown scalp and facial hair — the first hair he’d grown there in seven years. After three more months of therapy at 15 mg daily, the patient had completely regrown scalp hair and also had clearly visible eyebrows, eyelashes, and facial hair, as well as armpit and other hair, the doctors said.


“By eight months there was full regrowth of hair,” said co-author Dr. Brittany G. Craiglow. “The patient has reported feeling no side effects, and we’ve seen no lab test abnormalities, either.”

Tofacitinib appears to spur hair regrowth in a patient with alopecia universalis by turning off the immune system attack on hair follicles that is prompted by the disease, King said.

The drug helps in some, but not all, cases of psoriasis, and was mildly effective in this patient’s case, the authors said.

King has submitted a proposal for a clinical trial involving a cream form of tofacitinib as a treatment for alopecia areata.

He cited work by Columbia University scientist Angela Christiano as the reason he decided to try tofacitinib as a therapy in this patient with both alopecia universalis and psoriasis. She has shown thattofacitinib and a related medicine reverse alopecia areata in mice. King called her work exemplary and a clear example of how society’s investment in science research leads to improvement in human life.

“This case highlights the interplay between advances in science and the treatment of disease,” he said, “and it provides a compelling example of the ways in which an increasingly complex understanding of medicine, combined with ingenuity in treatment, benefits patients.”

The paper is titled “Killing Two Birds with One Stone: Oral Tofacitinib Reverses Alopecia Universalis in a Patient with Plaque Psoriasis.”

 Images available. http://news.yale.edu/2014/06/19/hairless-man-arthritis-drug-spurs-hair-growth-lots-it
Maybe if we shave our heads we can be taken seriously and finally get some additional trials going. Who's with me?

Side note: Google alopecia + psychogenic, and you'll see that alopecia is still considered a psych condition by the Overlords of Psychology. (Insert cursing here)
 
Messages
73
Likes
122
So I know that this thread is super old but I wanted to mention that I'm currently being seen by one of the top ME/CFS doctors in the world and they mentioned using this drug.
 

Gingergrrl

Senior Member
Messages
13,211
Likes
38,438
So I know that this thread is super old but I wanted to mention that I'm currently being seen by one of the top ME/CFS doctors in the world and they mentioned using this drug.
Was just curious, in what context is your ME/CFS doctor using this drug? Is it for something autoimmune similar to RTX or totally different?
 
Messages
73
Likes
122
I honestly have no idea. I can say that he is very focussed on CMV and the viral aspect of ME/CFS. At the end of our last appointment I just asked what the newest thing they are working on was he quietly mentioned this along with saying that they have big hopes for it. I'm seeing him in a couple of months and will be asking more info.
 

Gingergrrl

Senior Member
Messages
13,211
Likes
38,438
I honestly have no idea. I can say that he is very focussed on CMV and the viral aspect of ME/CFS. At the end of our last appointment I just asked what the newest thing they are working on was he quietly mentioned this along with saying that they have big hopes for it. I'm seeing him in a couple of months and will be asking more info.
Interesting and thanks!
 
Messages
73
Likes
122
@Gingergrrl I've looked for the medication online to buy but haven't found it. It doesn't seem to have a ton of side effects so I was thinking about trying it myself. I might just wait until I hear back from the Dr./Prof. before I go it alone
 

Gingergrrl

Senior Member
Messages
13,211
Likes
38,438
@Gingergrrl I've looked for the medication online to buy but haven't found it. It doesn't seem to have a ton of side effects so I was thinking about trying it myself. I might just wait until I hear back from the Dr./Prof. before I go it alone
I would wait to get more info (if it was me) so you'd know why they are looking at this med and if you are a good candidate for it. But I am more cautious until I am fairly certain the risk/benefit is worth it.
 

Learner1

Administrator
Messages
3,465
Likes
5,999
Location
Pacific Northwest
It may not be for everyone.

Quote from: https://en.m.wikipedia.org/wiki/Tofacitinib

Tofacitinib was not approved by European regulatory agencies because of concerns over efficacy and safety.[32] Animal studies with tofacitinib conducted prior to human trials showed some carcinogenesis, mutagenesis, and impairment of fertility.[33]

Warnings and precautions

Tofacitinib is required by US FDA to have a boxed warning on its label about possible injury and death due to problems such as infections, Lymphoma and other malignancies which can arise from use of this drug.[7]

Serious infections leading to hospitalization or death, including tuberculosis and bacterial, invasive fungal, viral, and other opportunistic infections, have occurred in patients receiving tofacitinib.

Epstein Barr Virus-associated post-transplant lymphoproliferative disorder has been observed at an increased rate in renal transplant patients treated with tofacitinib while on immunosuppressive medications.

Patients are warned to avoid use of tofacitinib citrate during an "active serious infection, including localized infections." Doctors are advised to use it with caution in patients that may be at increased risk of gastrointestinal perforations.

Laboratory Monitoring is recommended due to potential changes in lymphocytes, neutrophils, hemoglobin, liver enzymes and lipids. Tofacitinib claims to have no contraindications, however doctors are advised to reduce the patient's dosage when combined with "potent inhibitors of Cytochrome P450 3A4 (CYP3A4)," such as ketoconazole), or one or more combined medications that result in both moderate inhibition of CYP3A4 and potent inhibition of CYP2C19 such as fluconazole.

Furthermore, immunizations with live vaccines should be avoided by tofacitinib users.
 

Learner1

Administrator
Messages
3,465
Likes
5,999
Location
Pacific Northwest
Having journeyed through stage 3 cancer and learning a lot along the way, I learned the best way to treat cancer is not to get it in the first place... my dad died of non-Hodgkins lymphoma and my mom is dying from untreatable chronic lymphocytic leukemia.

One must weigh all the pros and cons of any intervention and individualized treatment, to be sure.

Best wishes...