New drugs under investigation for the treatment of alopecias

ABSTRACT

Introduction: Alopecia is a very common complaint in medical practice, which usually has a large psychological impact in patients. Treatment of alopecia is often difficult and frustrating for patients and clinicians owing to the slow growth rate of the hair, long treatment terms, limited efficacy, and possible adverse side effects.

Areas covered: This paper reviews the new and emerging treatments for two of the most common forms of alopecia, known as androgenetic alopecia and alopecia areata. A literature search of PubMed/MEDLINE and ClinicalTrial.gov was performed to gather information about active research on new treatments for alopecias. Websites of companies sponsoring clinical trials were also searched for interim result data.

Expert opinion: Many new therapies in two of the most common forms of hair loss have been developed and are currently being studied with encouraging results. In alopecia areata, JAK inhibitors are promising. The discovery of JAK inhibitors has prompted the research and identification of new molecules. In androgenetic alopecia, we are still looking for a topical treatment that is superior to topical minoxidil. However, stem-cell research is advancing and the goal to create new follicles or refresh dormant follicles may be realized in the near future.

Trial registration: ClinicalTrials.gov identifier: NCT02299297.

Trial registration: ClinicalTrials.gov identifier: NCT03570749.

Trial registration: ClinicalTrials.gov identifier: NCT02974868.

Trial registration: ClinicalTrials.gov identifier: NCT03137381.

Trial registration: ClinicalTrials.gov identifier: NCT03594227.

Trial registration: ClinicalTrials.gov identifier: NCT02553330.

Trial registration: ClinicalTrials.gov identifier: NCT02561585.

Trial registration: ClinicalTrials.gov identifier: NCT03315689.

Trial registration: ClinicalTrials.gov identifier: NCT03354637.

Trial registration: ClinicalTrials.gov identifier: NCT03651752.

Trial registration: ClinicalTrials.gov identifier: NCT03532958.

Trial registration: ClinicalTrials.gov identifier: NCT03359356.

Trial registration: ClinicalTrials.gov identifier: NCT02018042.

Trial registration: ClinicalTrials.gov identifier: NCT02684123.

Trial registration: ClinicalTrials.gov identifier: NCT02684097.

KEYWORDS:

• Alopecia
• alopecia areata
• androgenetic alopecia
• baricitinib
• bimatoprost
• BNZ-1
• JAK inhibitors
• latanoprost
• ruxolitinib
• setipiprant
• tofacitinib

Article highlights

• Oral JAK inhibitors are a promising new treatment for alopecia areata, and placebo-controlled clinical trials are underway.

• Efficacy of topical JAK inhibitors is still unknown.

• Several other targeted immunologic agents are in clinical trials for treatment of alopecia areata.

• Many new drugs are in development for androgenetic alopecia, but none have shown promise of superiority to existing treatments such as topical minoxidil.

• Novel targets for the treatment of androgenetic alopecia include the PGD2 receptor and the Wnt pathway.

This box summarizes key points contained in the article.

Declaration of interest

A Tosti is a consultant for P&G, DS Laboratories, Monat and Pfizer and is a principal investigator for Incyte, Aclaris, Lilly, and Nutrafol. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.