A new study has been set up in New York to see if people whose
hair loss has been caused by the autoimmune disorder alopecia areata can benefit from subcutaneous injections of a specialist eczema medication.
The drug is named dupilumab and is quite well known to people who cannot use or have had no success with topical creams on their eczema though it comes with a reported price tag of around $37,000 per year when sold under the brand name of Dupixent. The drug targets something called the IL-13 pathway, which has also been linked to
alopecia areata. The theory is that using dupilumab on people with alopecia areata may reduce their shedding and encourage regrowth.
Vexing condition
Alopecia areata is a vexing condition that can strike without warning and usually leads to sudden patchy hair loss, although more extreme variations of the disorder (
alopecia totalis and alopecia universalis) can lead to total baldness. Though
alopecia areata treatment is possible using existing medications, the approach taken by specialist
hair loss clinics is normally only effective when people present with the relatively mild, patchy form of the condition.
The New York trial is being overseen by the Icahn School of Medicine at Mount Sinai, and will involve a total of 54 people, half of whom will be given
dupilumab, with the other half being given a placebo. Each set of volunteers will have 24 doses over the course of several months and any regrowth will be measured at 24 and 48 weeks. It will be a randomised double-blind trial and participants will only be accepted if their alopecia areata affects at least 30% of their scalp. Around a third of the volunteers are expected to also present with eczema/atopic dermatitis.
In the School’s description of the trial, submitted in its clinicaltrials.gov registration, it states: “Data shows that IL-13 is significantly upregulated in both AD (atopic dermatitis) and AA (alopecia areata) lesions compared to nonlesional skin. It is very important to associate the clinical responses with suppression of this cytokine and related molecules as well as other pathway cytokines in skin tissues. Both the whole genomic profiling and individual molecular and cellular markers are very important in order to understand how well anti-IL-13 will change/suppress AA-associated pathways and compare with those that will be suppressed in AD.”
Among the many exclusion criteria for would-be volunteers are use of any oral
JAK inhibitors within 12 weeks before the start of the trial; the use of any systemic immunosuppressive medications; and also concurrent conditions that may also cause hairloss such as
traction alopecia. The study is not expected to be completed until the end of 2023.
Existing treatments can be effective
The past few years have seen numerous stories about potential new treatment options for alopecia areata emerge, some of which are estimated to potentially become available
as early as 2021. However, people with the relatively mild form of the disorder should note that existing treatments can be very effective.
In mild cases the hair should normally regrow naturally within up to 12 months, though if or when this hair growth will resume is unknown something which can be extremely troubling for those affected. In these cases when the rounded bald patches affect the scalp only professional treatment can often lead to very satisfactory results, as can be seen in Belgravia’s
alopecia areata success stories gallery.
The alopecia areata treatment provided via Belgravia’s specialists and pharmacies is for the scalp-only patchy hair loss version and involves recommended formulations of
high strength minoxidil being applied directly to the affected areas to help encourage regrowth through opening the potassium channels. This drug is usually paired with further appropriate
hair growth boosters tailored to the individual’s requirements and medical suitability.