Baricitinib Gets Korean Trial for Alopecia Areata

One of the many JAK inhibitor drugs that has recently been explored as a potential treatment for the autoimmune disorder Alopecia Areata is baricitinib.

This oral rheumatoid arthritis medication has already been explored by a number of researchers, including a team from the Department of Dermatology at Columbia University, USA, and the pharmaceutical company, Incyte, as a possible hair loss solution for mild to severe Alopecia Areata.

Now Lilly Korea has announced it has received the green light for a randomized, double-blind, placebo-controlled, adaptive phase 2/3 clinical trial from the Ministry of Food and Drug Safety - the Korean equivalent of the UK's MHRA and the FDA in America - to explore the drug for this same purpose.

Xeljanz versus Olumiant?

Lilly Korea manufactures baricitinib under the brand name of Olumiant for the Korean and American markets; this is referred to in the trial data as LY3009104. It is taken by rheumatoid arthritis patients once per day, which Korea Biomedical Review advises gives it a competitive advantage over Pfizer's rheumatoid arthritis medication, Xeljanz which is taken twice daily.

Whilst this 'competition' relates to the increasing number of rheumatoid arthritis patients reportedly choosing Olumiant over Xeljanz, it would appear the two medications may also be competing on the hairloss front too.

Xeljanz is the brand name for Pfizer-produced tofacitinib citrate, another JAK inihibitor which has also been explored - seemingly quite successfully - for the treatment of severe autoimmune alopecia.

In 2014, Yale University discovered its hair loss treatment potential when they used it experimentally to treat a plaque psoriasis patient who also happened to be bald due to Alopecia Universalis. There is currently no significantly effective treatment for this condition.

This is the most extreme form of Alopecia Areata and causes total baldness from head to toe, whereas Alopecia Areata causes patchy hair loss often called 'spot baldness' to the scalp only, and Alopecia Totalis leaves the scalp hairless and can also cause facial hair loss, including losing eyebrows and eyelashes.

The Yale patient experienced full hair regrowth after being treated with various doses of oral tofacitinib for eight months. The 25 year old had not previously grown hair for seven years, after this autoimmune disease was triggered.

Pfizer is still hoping to win the race to bring the first ever JAK inhibitor-based Alopecia Areata treatment for all forms of the often distressing disorder, with its two candidates PF-06700841 and PF-06651600.

However, pharmaceutical company, Aclaris Therapeutics was awarded patents relating to the use of tofacitinib as a treatment for Alopecia Areata, Totalis and Universalis, covering the USA and Japan in late 2017.

Alopecia Areata treatment options

It is estimated that the first fully authorised Alopecia Areata treatments capable of treating even the most extensive baldness caused by the condition, will be based on JAK inhibitors, and could be ready for approval and licensing by medical regulatory boards as early as 2021/2022.

Until then, Alopecia Areata treatment relating to the mild-to-moderate, scalp-only form has been shown to often produce promising results in adults. For those with more expansive forms or for children with any alopecia phenotype, hospital-based treatments such as steroids or topical immunotherapy may be beneficial. These do, however, generally tend to have a smaller success rate.

In cases where hair regrowth does not occur spontaneously - often a possibility within 12 months of it starting for scalp-only instances - a hair loss specialist or dedicated hair loss charity can often provide helpful advice, treatment recommendations where appropriate, and support.