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- Presentation
Alopecia Areata: New Therapies
Description
The lecture discusses the advancements and challenges in treating alopecia areata, focusing on the global adoption of JAK inhibitors such as tofacitinib, baricitinib, and ritlecitinib. The speaker highlights promising initial results from case reports that led to increased interest in these treatments, but emphasizes the difficulties faced in Brazil regarding access and affordability. Despite being legally approved, the high costs—over $1,000 monthly for official treatments—restrain patient access, with many living on low incomes. As a solution, compounded tofacitinib has emerged as a more affordable option, costing under $50 monthly. The speaker shares results from a personal experience treating 18 patients with compounded tofacitinib; 83% experienced a minimum 30% reduction in their severity score, with positive hair regrowth noted as early as eight weeks. However, the speaker also warns of the potential risks and challenges associated with compounded medications, including quality control. Emphasizing that JAK inhibitors represent a breakthrough in alopecia treatment, the speaker concludes with a strong message about the need to prioritize patient safety and address access issues in the healthcare system.
View moreConclusions
- JAK inhibitors are a revolutionary advancement in the treatment of alopecia areata.
- Despite their efficacy, high costs significantly hinder access to JAK inhibitors in many countries, particularly Brazil.
- Compounded tofacitinib shows promising clinical response in patients who cannot afford commercial options.
- The compounded formulation of tofacitinib is much more affordable at less than $50 per month compared to over $1000 for branded medications.
- Approximately 83% of patients experienced at least a 30% reduction in hair loss, demonstrating significant potential for efficacy.
- A median time of 8 weeks was noted for initial hair regrowth in responsive patients.
- Adverse events observed were manageable and similar to those reported in existing literature, though caution is necessary with compounded formulations.
- BG Craiglow and BA King. Killing Two Birds with One Stone: Oral Tofacitinib Reverses Alopecia Universalis in a Patient with Plaque Psoriasis. Journal of Investigative Dermatology (2014) 134, 2988-2990; doi:10.1038/jid.2014.260; published online 17 July 2014.
- Lauren C. Strazzulla, BA, Eddy Hsi Chun Wang, PhD, Lorena Avila, MD, Kristen Lo Sicco, MD, Nooshin Brinster, MD, Angela M. Christiano, PhD, and Jerry Shapiro, MD. Alopecia areata: An appraisal of new treatment approaches and overview of current therapies. Journal of the American Academy of Dermatology, 2017.