WALPOLE, Mass. — It turns out, Will Smith’s award show slap of Chris Rock was not the only news this week involving the disorder alopecia areata. Researchers at Yale Medical School in New Haven, Connecticut, are reporting a new drug triggered significant hair regrowth in patients severely affected by the condition.
“And the way that they figured out if the hair growth is significant -- it wasn’t just if you grew a hair or two,” said Natalie Mesinkovska, MD, PhD, Chief Science Officer for the National Alopecia Areata Foundation. “They wanted 80 percent of your scalp to be covered.”
The researchers conducted two trials while testing two different doses of the drug baricitinib against placebo. Some of the 1,200 participants got 2 mg a day for nine months; some got 4 mg. And then a third group was dosed with a placebo.
Between the two trials, 36-39% of those dosed with 4 mg saw significant hair regrowth compared with 19-23% dosed with 2 mg. In the placebo group, just 3-6% grew a significant amount of hair.
The researchers published results of the two trials in the New England Journal of Medicine.
Baricitinib works to regrow hair, by calming the pathological tendencies of the immune systems in those with alopecia areata.
“We know that the immune system gets a little too excited and it attacks the hair follicle unnecessarily,” Mesinkovska said. “And the hair falls out.”
One advantage of baricitinib is that it comes as an oral tablet. Other immunomodulators are sometimes given only by infusion.
Mesinkovska said safety data is needed from longer trials, but so far, the drug appears well tolerated.
“When you try to suppress the immune system, you always worry about at least two things,” Mesinkovska said. “What is the job of the immune system? It is to clear your body from infections and from cancers. Someone’s going to be on this for a long time. So we have to make sure that they’re safe. Not much has come up. Acne, maybe some upper respiratory infections, some lab abnormalities, but nothing bad.”
Chrissa Kaselis developed alopecia 25 years ago, after graduating from college.
“I remember hearing the word ‘alopecia’ but I really didn’t know what alopecia was,” she said. “It was very difficult. I had a lot of hair. and a lot of it I was able to hide for quite some time.”
But Kaselis’s hair loss continued -- despite use of steroid and cortisone injections to the scalp.
“The patches were so large that I just... at the age of 30 after I got married, asked my husband to shave my head,” she said.
Her hair never grew back. Today, Kaselis leads an alopecia support group in the Boston area -- where some members have a form of the disease that’s cyclical.
“I do know people from my alopecia support group who have lost their hair at times and then their hair has regrown again, on its own no drugs or anything like that,” Kaselis said.
That rollercoaster can be a painful one, she said. And while she finds the prospect of a new drug exciting, Kaselis is worried about side effects -- and whether regrown hair would fall out if someone stopped taking the drug.
While those are important reasons to hold off on taking the drug, if and when it becomes available, Kaselis has another one.
“I don’t want my hair to grow back again, to tell you the truth,” she said. “I’m happy with who I am at this point. It’s taken me a long time to get here but I’m happy with it.”
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