Research Into Immunosuppressant Drugs to Regrow Hair Raises Concerns

Drugs that suppress the activity of the immune system typically have serious side effects Photo by Fixers UKA recent report from the New York Times regarding research out of Columbia University Medical Center caught our attention. The story, "New Drug Helps Some Bald Patients Regrow Hair," by Pam Belluck, describes early successes by a team lead by Dr. Julian Mackay-Wiggan, director of Columbia’s dermatology clinical research unit, using a janus kinase (JAK) inhibitor called ruxolitinib on a small group of women and men suffering from alopecia areata. As we have reported in several articles over the years, alopecia areata is a common autoimmune skin disease that affects approximately two percent of the population overall, including more than 6.5 million people in the United States. It results in the loss of hair on the scalp and elsewhere on the body. It usually starts with one or more small, round, smooth patches on the scalp and can progress to total scalp hair loss (alopecia totalis) or complete body hair loss (alopecia universalis). The disease is highly unpredictable and cyclical. Hair can grow back in or fall out again at any time, and the disease course is different for each person. The National Alopecia Areata Foundation is a great source of information about the disease. The idea of using JAK inhibitors to treat alopecia stems from a genome analysis that determined that hair follicles in alopecia areata patients emit a signal that draws immune cells to attack. Her team identified specific cells involved and found genetic similarities to unrelated autoimmune diseases. Dr. Mackay-Wiggan and her team tested whether a drug approved for a bone marrow disorder could help people with alopecia. Earlier, they successfully tested two JAK inhibitors on mice. According to their study published in the journal Nature Medicine, they followed that up with testing ruxolitinib, on seven women and five men with moderate to severe alopecia areata (more than 30 percent hair loss). While the study is continuing, the results for several participants were significant. Within five months of starting treatment, three patients had total hair regrowth. Dr. Mackay-Wiggan told the New York Times:

“It appears to work — not in everyone, but in the majority. “We need a lot more data on the long-term risks in healthy individuals. But it’s certainly very exciting in terms of hair growth. It was surprising how quickly and impressively the growth occurred.”

As exciting as this development may seem, we join others in urging patience and even caution until further research is conducted. Drugs that suppress the activity of the immune system (immunosuppressant drugs) typically have serious side effects, including liver damage, infections, blood problems and other health issues. The Times reports that Dr. Mackay-Wiggan's team also plans to test another JAK inhibitor, tofacitinib, which is approved for rheumatoid arthritis and grew hair on mice. Earlier, a researcher at Yale found that tofacitinib caused full hair growth and no negative effects for a man with alopecia universalis. Perhaps just as informative as the study itself is the backlash that it generated online. Below we've excerpted a few comments from readers of the New York Times article. While comments often are full of bluster and venom, these strong words are worthy of consideration as patients examine potential treatments in the future:

Sonny Lundin: "You don't really want to take immuno-spressant drugs unless you need to, like when you have a foreign organ transplated into your body. Immuno-supressants is exactly what you DON'T need! You need 100% of your immune system to make sure you can kill infections attacking you." Margo: "First, do no harm" is the primary principle of medical therapy. While alopecia totalis--total baldness of the scalp--and alopecia universalis--complete loss of body hair--are very difficult to treat and are psychologically devastating, they are not life threatening. The "biologic" immune modulators can cause serious infections, heart failure, aggravate MS and possibly lymphoma." A Reader: "Using a drug which is possibly toxic to my overall health is not acceptable to me. As a person with alopecia areata myself I would love to have a cure but this drug is not worth the risk - especially to a young person. Mother Nature has enough surprises in store for us, why add to her kit-bag?" Anna Clebone: "As other posters have noted, the risks of these drugs for severe, long term side effects are high, which is why they are currently used for life threatening illnesses. As a physician and woman with alopecia universalis, I welcome research into this field, but this is a first step, not a 'cure-all'."

These are very valuable thoughts from the community and we at Arocha Hair Restoration echo these cautions. Nonetheless, it is important to stay abreast of the latest medical advances, knowing that over time some of these discoveries may lead to potential treatments that could become options in the future.