How effective really is the drug Ruxolitinib in the treatment of Alopecia Areata?

The drug is from Novartis and acts in the auto immune system. It is supposed to be applied for the treatment of myelofibrosis. Do you know anything about this medication?

Doctor Answers 6

Ruxolitinib and Tofacitinib for Alopecia areata - How good are they?

These drugs are known as JAK inhibitors because they inhibit a pathway inside cells known as the JAK pathway. Ruxolitinib (also known as Jakaf/Jakavi) inhibits JAK 1 and 2 and Tofacitinib (also known as Xeljanz) inhibits JAK 1 and JAK 3.

Ruxolitinib can be quite effective, but that does not mean it's the first drug any patient should reach for or ask about. In fact, it's not even the second drug. Given how new it is and the number of potential side effects, other treatments should be tried first. These drugs, in my opinion, are only for more advanced stages of alopecia areata. I never use these medications for a patent with one or two patches of alopecia areata, but I will use these medications for someone with extensive hair loss - who has not responded to conventional treatments. 

 Two new studies published recently in the journal JCI Insight support their benefits of these drugs

1) One new study by Mackay-Wiggans and colleagues reported results of an open label trial of 12 patients with moderate to severe alopecia areata using oral ruxolitinib at a dose of 20 mg twice daily for 3-6 months followed by 3 months off the drug. 9 of 12 patients reported "significant" growth with no serious adverse events.

2) In another study, investigators from Yale and Columbia University reported results of a study of 66 patients with advanced alopecia areata (including totalis and universalis). Patients received tofacitinib 5 mg twice daily for three months. Patients with alopecia totalis and universalis were less responsive than patients with alopecia areata but overall about one-third of patients experienced significant improvement. What was also very important to note was patients relapsed very quickly when the medication was stopped – losing hair within 8.5 weeks of stopping.

 

Certainly, these JAK inhibitors, including ruxolitinb  continue to show evidence of being helpful for patients with advanced alopecia areata. We have been using tofacitinib for some time now and it's evident now that in advanced alopecia areata it offers the potential to help a lot. The study I mentioned second reminds us that these are not cures and that patients lose hair when the treatment is stopped.

 

 

REFERENCE

Mackay-Wiggan J et al.  Oral ruxolitinib induces hair growth in patients witih moderate-to-severe alopecia areata. JCI Insight 2016

Kennedy Crispin M et al. Safety and efficacy of the JAK inhibitor tofacitinib citrate in patients with alopecia areata. JCI Insight 2016.

How effective really is the drug Ruxolitinib in the treatment of Alopecia Areata?

Loss of hair is a natural process when it is between the limits that the body can restore them. When the capacity of the body to restore the hair loss is beaten by the excessive hair loss then we can name this situation something that should be treated. Women started to experience balding even more in the last 2 decades. It is getting more and more common also in women population. However it is also good to know that this problem is also treatable when it is present in women.

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Bulent Cihantimur, MD
Turkey Plastic Surgeon
4.9 out of 5 stars 79 reviews

Other treatment options are available for alopecia areata

Ruxolitinib is a monoclonal antibody that is FDA approved used for rheumatoid arthritis. It has been shown in limited studies to regrow hair in rats. A very small subset of patients tested have had initial growth of hair, however it is not FDA approved for alopecia areata, and long term results are unknown. Other treatment options are available for alopecia areata.

Craig L. Ziering, DO
West Hollywood Hair Restoration Surgeon
4.5 out of 5 stars 6 reviews

How effective really is the drug Ruxolitinib in the treatment of Alopecia Areata?

Thanks for your query. Ruxolitinib is a biological drug that works on immunomodulation. It works best for myelofibrosis. There are various treatment options available for alopecia areata like intralesional steroids; topical immunomodulators, minoxidil, etc. hope it helps


All The Best

Ajaya Kashyap, MD
India Plastic Surgeon
4.9 out of 5 stars 132 reviews

Real Results for Hair Loss

This is still a relatively new treatment. I have great results with progesterone and PRP injections in the scalp. Also hair transplants are another option. See an expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Ruxolitinib

This is a new drug for the treatment of alopecia areata. There may be value for genetic alopecia but it is to early to know this

William Rassman, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 27 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.