The 17-year-old patient suffered from alopecia areata, a disfiguring autoimmune disease that affects tens of millions of people worldwide and has limited treatment options. Alopecia areata may cause spotty hair loss or complete loss of scalp hair, eyebrows, eyelashes and all other body hair. The patient in this study, published Dec. 9 in JAMA Dermatology, had tried multiple treatments with no success.
To treat the condition, Dr. Brett King, assistant professor of dermatology, and his co-authors, Dr. Brittany Craiglow and Daniel Tavares, devised a topical formulation of an oral medication used to treat bone marrow diseases.
The drug, ruxolitinib, belongs to a class of medications called JAK inhibitors, which alter the immune system. King had previously used another oral JAK inhibitor, tofacitinib, to restore hair to a male patient with alopecia universalis in 2014, and other researchers have shown that oral ruxolitinib restores hair in this condition, too.
After 12 weeks of treatment at Yale, the patient had complete restoration of eyebrow hair. (Photos by Dr. Brett King)
For this study, the patient applied the cream twice a day to the scalp and eyebrows. After 12 weeks, she had complete restoration of eyebrows and partial regrowth of her scalp. After switching from the cream to a pill form to continue her treatment, the patient now has a full head of hair.
The outcome was better than anticipated, said King. “The results with the cream are as good as what is expected with pills over the same amount of time,” he noted. “The results are remarkable.”
A cream is more appropriate for many patients with alopecia areata, including those concerned about possible risks, such as cancer or infections, that have been associated with oral JAK inhibitors, said the researchers. No side effects were observed in the patient using the cream.
“This is a first in the treatment of a devastating and common autoimmune disease and builds on our recent efforts to show that treatment is within reach for millions of people who suffer from alopecia areata and will hopefully continue to build interest in finding solutions for this and other autoimmune diseases,” said King.
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