番茄社区

Advancements in our understanding of alopecia areata have led to new and emerging treatments, including the recently approved Janus kinase (JAK) inhibitors baricitinib (Olumiant) and ritlecitinib (Litfulo).

In this exclusive 番茄社区 video, , of Yale School of Medicine in New Haven, Connecticut, discusses these options along with investigational deuruxolitinib, and what they will mean for pediatric alopecia areata patients.

Following is a transcript of her remarks:

For patients with severe alopecia areata -- meaning extensive hair loss, and/or those who are really having a significant impact on their quality of life or who have involvement of eyebrows and eyelashes -- most of those patients really are unlikely to have a cosmetically acceptable response with anything other than an oral JAK inhibitor.

So what is really exciting is that fast forward to next year, we may actually have three choices. And so I think the decision tree is going to look different depending on the patient's age and severity. I think what's really interesting is that we're starting to see that failure of one JAK inhibitor doesn't necessarily mean failure of another. So I think when I first started doing this, I thought, "Oh, well if you don't respond to one, then probably you're not going to respond to another one."

But these [JAK inhibitors], while they have very similar mechanisms, they are all slightly different -- so where their binding affinity, how they bind, which JAK proteins they inhibit, is all a little bit different. And so I think for people who don't respond well to the options currently available, we may be able to try another option down the line, which is really exciting.

So I think this is really going to become a disease that I think we think of as largely treatable, which is very different from what we thought even 3 or 5 years ago. And I think also what's exciting is that we'll see clinical trials in younger patients.

So baricitinib right now is being studied down to age 12. Hopefully we'll see trials down to age 6 for baricitinib and ritlecitinib. And so that means just more and more patients will be able to be treated. And this is largely a disease of young people. So we often see an onset in childhood. And we also know that what we call duration of your current episode of alopecia areata -- meaning how long have you had very severe disease -- that number influences response to treatment.

So basically the earlier we can get in and treat the better. So right now there are patients, because there isn't an approved option in their age group, they may miss their opportunity to regrow. But that again, within the next several years, I think really will change. And this will be a disease that most people don't have to live with if they don't want to.

Comment