Tuesday, August 19, 2014

Ruxolitinib a cancer drug restores hair growth in Alopecia areata

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Alopecia areata causes hair loss for more than 6.5 million people in the US. Now, researchers have discovered that a drug already approved by the Food and Drug Administration for treatment of a rare bone marrow disease - Ruxolitinib - could restore hair growth in these patients. The research team, led by Dr. Raphael Clynes and Angela M. Christiano of Columbia University Medical Center (CUMC), recently published the initial findings of their ongoing clinical trial in the journal Nature Medicine.

Alopecia areata is a disease whereby the immune system attacks hair follicles - the parts of the skin from which hair grows. The hair follicles send a "danger signal" to immune cells, which encourages them to launch an attack on the follicles. The majority of people with this disease experience bald patches over their head, face and body, although the condition can cause total hair loss in some cases.  It is found that a certain set of T cells responsible for attacking hair follicles.

Ruxolitinib (INC424, INCB18424, trade names Jakafi and Jakavi, by Incyte Pharmaceuticals and Novartis) is an FDA Approved  prescription only oral drug for the treatment of intermediate or high-risk myelofibrosis, a type of bone marrow cancer. It is also being investigated for the treatment of other types of cancer (such as lymphomas and pancreatic cancer), for polycythemia vera, for plaque psoriasis. In November 2011, ruxolitinib was approved by the U.S. Food and Drug Administration (FDA) for the treatment of intermediate or high-risk myelofibrosis

Reported Mechanism of Action of Ruxolitinib is as a Janus kinase inhibitor with selectivity for subtypes JAK1 and JAK2 of this enzyme.  JAK1 and JAK2 recruit signal transducers and activators of transcription (STATs) to cytokine receptors leading to modulation of gene expression.

In this above mentioned study, the researchers report on the findings of a small, open-label clinical trial of ruxolitinib on patients with moderate-to-severe alopecia areata, defined as having more than 30% hair loss.
Early results of the trial revealed that in three of the participants, hair growth was fully restored within 4-5 months of treatment initiation. Furthermore, the T cells that attack the hair follicles were no longer present in the participants' scalps.

The reported side effects of Ruxolitinib have included herpes zoster (shingles) (1.9%),  weight gain (7.1%). Laboratory abnormalities have included alanine transaminase (ALT) abnormalities (25.2%), aspartate transaminase (AST) abnormalities (17.4%), and elevated cholesterol levels (16.8%)

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