“I prefer not to have hair”. A new drug for alopecia areata arouses emotions

The US Food and Drug Administration (FDA) has approved the first oral drug for alopecia areata. The information aroused considerable excitement, although patients suffering from alopecia are far from enthusiastic. Why? – In such treatment, hair is provided if you are taking medications. When you set aside, they will fall out. I prefer to be without hair than to take medications all my life – says Aleksandra Przybylska, who has been struggling with the disease for over 10 years.

1. American patients suffering from alopecia may already turn to baricitinib
2. It is a drug that is used, inter alia, in in the treatment of rheumatoid arthritis (RA) and atopic dermatitis (AD). The substance is also administered to patients hospitalized due to COVID-19
3. Research shows that after 36 weeks of using baricitinib, almost 40 percent. people taking a high dose grew 80 percent. hair.
4. Treatment of alopecia areata is difficult and the effects are often short-lived. – I found that if I am to take such powerful drugs throughout my life, which do not know how they affect my body and what their long-term effects are, I would like to thank them, says Aleksandra Przybylska
5. More information can be found on the Onet homepage

Baricitinib for alopecia

The drug that has been approved by the FDA is baricitinib, an immunosuppressive substance belonging to Janus kinase (JAK) inhibitors. These are enzymes that are transmitters of signals from receptors for cytokines and growth factors involved in the inflammatory process. By inhibiting the activity of these enzymes, the medicine can stop or slow down the sending of an inflammatory signal. In short, it disrupts the cellular pathway that leads to inflammation.

Baricitinib is used in the treatment of RA and AD. During the COVID-19 pandemic, the license was extended to treat patients hospitalized due to coronavirus infection. Thanks to the FDA’s decision, the use of the substance has now been extended to include a severe form of alopecia areata.

The approval of the drug for the treatment of alopecia was preceded by a study of 1200 adults struggling with the disease. Patients were divided into three groups, one of which received a lower dose of the drug (2 milligrams per day), the second received a higher dose (4 milligrams), and the third was a placebo group.

After 36 weeks of using baricitinib, almost 40 percent. people taking the higher dose grew 80 percent. hair. In the case of the lower dose, it was 23%, while in the placebo group – 5%. What’s more, about 45 percent people in the higher dose group also noticed a significant regrowth of eyebrows and eyelashes.

The most common side effects included upper respiratory tract infections, headaches, acne, high cholesterol, and an increase in an enzyme called creatine phosphokinase.

The rest of the text below the video.

“I’d rather be without hair than take medications all my life”

Among patients struggling with alopecia, the above information aroused mixed feelings. On the one hand, approval of a new substance in the treatment of a disease gives hope, on the other – guarantees that this method of therapy will work in a specific case, no one can give.

The fact that the treatment of alopecia areata does not always bring the expected results, says Aleksandra Przybylska, known as BaldOla, who runs a profile on social media in which she talks about her disease and the process of its acceptance.

He has been struggling with alopecia for over 10 years. She used various forms of therapy, but none of them brought the expected result.

– It started with steroids. Three approaches, nearly a year of use, but the effects are poor – he admits.

The hair did grow back (then the disease did not cover the entire head, but only its areas, including the area behind the ears), but as soon as Ola stopped taking her medications, the hair fell out again. The worst, however, were the side effects of their use.

– I was very swollen and I felt at least uncomfortable in my body. Apart from that I was not happy to take such strong substances my whole life, I was only 18 years old – he adds.

The second method, which the doctor suggested, was taking cyclosporine. It is a potent immunosuppressive drug that can be effective but can cause severe side effects at the same time. For this reason, when using it, you should undergo control tests to notice the negative effects of the substance on the body in time.

– I remember that I had to wait for the cyclosporine to start working – the hair only started to grow after about two months after starting the therapy. During several months of treatment, I had blood tests every 30 days to check for side effects. Eventually I gave up the drug because my hair started falling out again – she says.

The third and, as it turned out, the last step in the treatment of alopecia areata in bald people was phototherapy, i.e. treatments of irradiating the whole body with PUVA lamps. This method gave hope.

– The hair actually started to grow, almost all over the head. Unfortunately, when after completing the first, six-month therapy, I was about to start another one, all of them fell out. It was the week before the second round of the session. I tried again, but after five months, the hair roots didn’t even twitch – he recalls.

The doctor proposed to return to cyclosporine and try the therapy again, but Ola has already made a decision: she does not want to cure her disease, she will try to accept it.

– I have been undergoing treatment almost all my life. As a child, I had epilepsy and took medication for it. Then a short break and the diagnosis: alopecia areata. I found that if I am to take such powerful drugs throughout my life, which do not know how they affect my body and what their long-term effects are, I would like to thank him – he explains.

Four years have passed since then. As she admits, she struggled for a long time to tame and accept that the disease is incurable. – Now I accept that I have no hair. I see it as an appearance trait, not a disease. The only recipe for this disease is to accept it – believes Ola.

When asked if information such as the approval of the first oral pill for alopecia in the United States tempt her to try again, she replies without hesitation:

– Not. I would have to be 100 percent. the certainty that such a drug will work, the hair will grow back and never fall out, which is rather impossible. In such treatment, hair is there if you are taking medications. When you set aside, they will fall out. I prefer to be without hair than to take medications all my life, especially since, for example, if you are planning to get pregnant, you still have to stop taking them. I do not want such restrictions in my life – he emphasizes.

What is alopecia?

Alopecia, also known as alopecia areata, is an autoimmune skin disease. It is manifested by the occurrence of the so-called alopecia foci, i.e. patches of smooth skin in the place where it is usually hairy. It can affect any part of the body and include hair on the head, eyebrows, eyelashes, hair on the arms, legs and armpits, as well as pubic hair. Hair can fall out locally or from all over the area where it naturally occurs.

The causes of the disease are still unknown. Alopecia areata is most likely the result of several factors: from genetic, through immunological, to mental and related to the nervous system. The course of the disease and the severity of symptoms is an individual matter. For many patients, hair loss can also lead to psychological disturbances, resulting from a feeling of lack of self-acceptance, which can aggravate the inflammation and thus the symptoms.

Treatment of alopecia areata involves the use of substances that stimulate the growth of the hair follicles. This includes glucocorticosteroids (administered intradermally and topically), cygnolin and minoxidil, and as part of systemic treatment also cyclosporine. Patients also undergo treatments such as photochemotherapy (PUVA or PUVA-turban) and narrowband UVB phototherapy, as well as mesotherapy, cryomassage and carboxytherapy.

We encourage you to listen to the latest episode of the RESET podcast. This time Kamila Wykrota, the resilience trainer, will tell us about what resilience is. How does the ability to adapt to changing circumstances and react to adversities affect our quality of life? You will find out by listening to the latest episode of our podcast.