New treatment option shows promise for skin and hair conditions

Board-certified dermatologist Brett King, MD, MPH, FAAD, an assistant professor of dermatology at the Yale School of Medicine in New Haven, Conn., is at the forefront of research into new uses for a class of drugs known as Janus kinase inhibitors, or JAK inhibitors. Recent studies suggest that these medications can disrupt the immune response that fuels alopecia areata, which can cause patchy or total hair loss; atopic dermatitis, which causes severe itch and red rash; and vitiligo, which causes the skin to lose its color.

"While alopecia areata, atopic dermatitis and vitiligo may not seem alike on the surface, they are all fueled by the body's immune system," Dr. King says, "and JAK inhibitors seem to address immune system dysfunction in all three diseases. I believe that this class of medicines is going to redefine how dermatologists approach these diseases and provide a revolutionary new therapy for patients."

A relatively new class of drug, JAK inhibitors were approved about five years ago by the U.S. Food and Drug Administration to treat rheumatoid arthritis and bone marrow disorders. After researchers at Columbia University in New York used these medications to successfully treat alopecia areata in mice, Dr. King used a JAK inhibitor off label in a human patient with the condition. After observing hair regrowth in this patient and others, he turned to patients with atopic dermatitis and vitiligo, who experienced significant improvement in their symptoms after taking JAK inhibitors.

While these results are promising, Dr. King says, JAK inhibitors are not currently FDA-approved for the treatment of alopecia areata, atopic dermatitis or vitiligo. The next step toward that end, he says, would be for pharmaceutical companies to conduct large-scale clinical trials, which are already in progress for atopic dermatitis and alopecia areata.

"If JAK inhibitors are approved for dermatologic use, these medications would provide dermatologists with a powerful tool for treating multiple common diseases that have a profound negative impact on patients," Dr. King says. "We need new and innovative treatments to help our patients, and for those with alopecia areata, atopic dermatitis and vitiligo, JAK inhibitors could be a life-changing therapy."