Home Medizin Wichtige Reaktionen bei narbigem und vollständigem Haarausfall

Wichtige Reaktionen bei narbigem und vollständigem Haarausfall

von NFI Redaktion

Recent data presented at the 2024 American Academy of Dermatology (AAD) annual meeting highlighted the significant hair regrowth seen in separate studies evaluating treatments for severe forms of alopecia with Januskinase (JAK) inhibitors.

One study focused on Brepocitinib for scarring alopecia (CA), a form of hair loss for which there are currently no approved therapies. The other study, a sub-analysis of Phase 3 trials with Ritlecitinib for Alopecia areata (AA), showed hair regrowth in the subgroup of patients entering the study with Alopecia totalis or Alopecia universalis (AT/AU).

According to April W. Armstrong, MD, MPH, Professor and Chair of Dermatology at the University of California, Los Angeles, the CA study reflected clinical response to changes in CA biomarkers suggesting a potential breakthrough. Emma Guttman-Yassky, MD, PhD, Professor of Dermatology and Immunology and Director of the Laboratory for Inflammatory Skin Diseases at the Icahn School of Medicine at Mount Sinai, New York City, who led the study, stated, „This is the first placebo-controlled clinical trial with an oral JAK inhibitor showing not only that scarring alopecia can be reversible but also providing insights into the mechanism of action and indicating which patients might benefit the most.“

Scarring Alopecia and Brepocitinib

The scarring alopecia study randomized 49 patients with CA in a 3:1 ratio to receive Brepocitinib, a First-in-Class inhibitor targeting both JAK1 and TYK2, or placebo. The primary endpoint of the study, due to its small size, was the change in CA biomarkers, with the secondary outcome being clinical response. Nine patients had frontal fibrosing alopecia (FFA), 16 had Lichen planopilaris (LPP) alopecia, and 24 had central centrifugal cicatricial alopecia (CCCA).

The data showed a decrease in all four key scalp inflammation biomarkers in the combined FFA/LLP group, while the placebo group saw an increase in these markers. In the CCCA subgroup, a similar pattern was observed for two of the biomarkers, with participants under Brepocitinib showing a decrease and those under placebo showing an increase.

Marguerite Meariman, MD, presented the results and noted improvements in disease activity indices under Brepocitinib, especially in the FFA/LLP group. The clinical activity improvements were dramatic and noticeable within 4 weeks of starting therapy.

Regarding Ritlecitinib for AT/AU, the analysis of patients with these conditions showed promising results in hair regrowth. Melissa Piliang, MD, Professor of Dermatology at the Cleveland Clinic, presented data indicating that approximately 50% of patients achieved significant hair regrowth after 24 months of treatment. Responses continued to improve over time, with a substantial number of patients reaching a SALT score indicating 90% or more hair growth.

Piliang emphasized the importance of early AA treatment for optimal outcomes and highlighted the need for lifelong therapy with JAK inhibitors, as discontinuation may result in the loss of response. Further studies are planned to explore the long-term efficacy of JAK inhibitors in these conditions.

Speakers at the AAD annual meeting on March 9, 2024, in San Diego, California, reported on these findings. Financial disclosures were made by the presenters to ensure transparency and avoid conflicts of interest.

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