For almost forty years, The Griffin Center of Hair Restoration and Research has been on the cutting edge of research into the prevention and treatment of hair loss. Recently there has been a great deal of talk about how Xeljanz®, an anti-inflammatory drug used in the treatment of rheumatoid arthritis, may be able to cause significant hair regrowth in patients suffering from some forms of hair loss.
Xeljanz® (tofacitinib) is a medication that calms down the immune system. Normally, our immune systems do a good job of protecting our bodies from foreign substances such as bacteria and viruses. It recognizes its own cells and does not see them as foreign. When individuals suffer from an auto-immune disease, however, the body’s own immune system essentially begins attacking itself. In rheumatoid arthritis this causes pain and swelling at the joints; in alopecia areata the inflammation occurs in the scalp, shutting down the generation of new hair and causing existing hair to fall out.
Xeljanz® is a JAK inhibitor, which means that it interferes with cell signaling that causes inflammation. Previously, Xeljanz® had been used to treat the inflammation associated with rheumatoid arthritis, and so it was theorized that, since alopecia areata is also the result of inflammation caused by auto-immune response, the drug might be able to treat this condition as well, even though it is currently not FDA-approved for this purpose. When Xeljanz® was used on a patient who had suffered from alopecia universalis, a severe form of alopecia areata that results in the complete loss of hair all over the body, the patient experienced full regrowth of hair on his head, as well as the return of the eyebrows and eyelashes he had lost, in just eight months. This treatment was using the oral form of Xeljanz for over 6 months costing about $2000 per month. Topical Xeljanz does also work for psoriasis and we are looking at ways to keep the costs down for a topical formula.
In alopecia areata, the hair follicle does remain capable of producing hair; it is only the ongoing action of the immune system that keeps the follicle in a continual dormant state. Many patients can experience remission, or periods of time when the disease stops acting on the body and the immune system behaves normally. During these periods, hair regrowth typically occurs. By inhibiting the immune response, Xeljanz® seems to have allowed the natural growth of hair to resume. It is, unfortunately, unclear whether the effects will remain if the drug treatment is discontinued, or if the disease will simply resume once more. It is also important to note that alopecia areata and its related conditions affect only about 2% of the population. Androgenetic alopecia, or pattern baldness associated with age, affects approximately ten times as many people and is not caused by auto-immune response. So it will not benefit from treatment with Xeljanz®.
Further studies on Xeljanz® and its role in the treatment of auto-immune hair loss need to be conducted, but this is a promising advance in the hair restoration field. Peony extract has also received press regarding its use in this autoimmune problem, as well as other problems with the same mechanism. Several of our patients are now trying the extract, which costs much less than Xeljanz.
If you have questions about hair loss causes and treatments, please contact The Griffin Center today. Be sure to also visit our website and follow us on Facebook, Twitter, and Google+ for more hair loss information.