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Oral Tofacitinib reverses alopecia universalis in a patient with plaque psoriasis


A man with almost no hair on his body has grown a full head of it after a novel treatment by clinicians at Yale University.
There is currently no cure or long-term treatment for alopecia universalis, the disease that left the 25-year-old patient bare of hair. This is the first reported case of a successful targeted treatment for the rare, highly visible disease.
The patient has also grown eyebrows and eyelashes, as well as facial, armpit, and other hair, which he lacked at the time he sought help.

The patient had previously been diagnosed with both alopecia universalis, a disease that results in loss of all body hair, and plaque psoriasis, a condition characterized by scaly red areas of skin. The only hair on his body was within the psoriasis plaques on his head. He was referred to Yale Dermatology for treatment of the psoriasis. The alopecia universalis had never been treated.

Researchers believed it might be possible to address both diseases simultaneously using an existing FDA-approved drug for rheumatoid arthritis called Tofacitinib citrate ( Xeljanz ). The drug had been used successfully for treating psoriasis in humans. It had also reversed alopecia areata, a less extreme form of alopecia, in mice.

After two months on Tofacitinib at 10 mg daily, the patient’s psoriasis showed some improvement, and the man had grown scalp and facial hair.
After three more months of therapy at 15 mg daily, the patient had completely regrown scalp hair and also had clearly visible eyebrows, eyelashes, and facial hair, as well as armpit and other hair.

By eight months there was full regrowth of hair. The patient has reported feeling no side effects, and researchers have seen no lab test abnormalities.

Tofacitinib appears to spur hair regrowth in a patient with alopecia universalis by turning off the immune system attack on hair follicles that is prompted by the disease.

Tofacitinib helps in some, but not all, cases of psoriasis, and was mildly effective in this patient’s case. ( Xagena )

Source: Yale University, 2014

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