FDA's new hair restoration drug should be used with caution

The new FDA-approved drug for alopecia has side effects, so in addition to ruling out latent tuberculosis, we need to test liver and kidney function. Full screening is essential, says Dr. Sunil Tolat, consultant dermatologist at BJ Government Medical College in Pune

Little did Oscar host Chris Rock know that commenting on actress Jada Pinkett Smith's hair loss would highlight the emotional trauma experienced by sufferers of alopecia areata.

 This autoimmune disease, which manifests as hair loss, can be life-changing in some cases – total hair loss, including eyelashes and eyebrows, nose hair, and ear hair.

According to a statement from the US Food and Drug Administration, the body attacks its hair follicles, causing hair loss. Olumiants are inhibitors that block the activity of one or more of a specific family of enzymes that block pathways leading to inflammation. Baricitinib, a drug by Eli Lilly, restores hair by blocking the immune system from attacking the hair follicles. It treats the whole body, not a specific location. The drug's efficacy and safety were tested in two randomized, double-blind, placebo-controlled studies in patients with at least 50% scalp hair loss.

What does this breakthrough mean for India? Tofacitinib - similar to baricitinib - is a new oral Janus active kinase inhibitor used to control rheumatoid arthritis and is already being used to treat this disease. It is readily available in India at an affordable price (Rs 25-50 per tablet). 

Dr. Sunil Tolat, consultant dermatologist and an honorary professor at BJ Government Medical College, Pune, says that, unlike male or female model baldness, alopecia areata requires a treatment tailored for each patient. He points out that existing treatments can support hair growth and that topical corticosteroids can also help, along with anti-inflammatory drugs that suppress the immune system.