The novel treatment saw the researchers give the patient an oral dose of tofacitinib citrate, a drug normally taken for rheumatoid arthritis, and is the first reported case of a successful targeted treatment for the rare, highly visible disease, alopecia universalis.
The researchers found that the drug treats alopecia by turning off the immune system's attack on hair follicles, and they have now submitted a proposal for a clinical trial of a cream form of tofacitinib for treatment of alopecia.
The patient has also grown eyebrows and eyelashes, as well as facial, armpit, and other hair, which he lacked at the time he sought help.
"The results are exactly what we hoped for," says Brett A. King, M.D., assistant professor of dermatology at Yale University School of Medicine and senior author of a paper reporting the results online June 18 in the Journal of Investigative Dermatology.
"This is a huge step forward in the treatment of patients with this condition. While it's one case, we anticipated the successful treatment of this man based on our current understanding of the disease and the drug. We believe the same results will be duplicated in other patients, and we plan to try."
The patient had previously been diagnosed with both alopecia universalis, a disease that results in loss of all body hair, and plaque psoriasis, a condition characterized by scaly red areas of skin.
King believed it might be possible to address both diseases simultaneously using the existing FDA-approved drug tofacitinib citrate, as it had been used successfully for treating psoriasis in humans and also reversed alopecia areata, a less extreme form of alopecia, in mice.
"There are no good options for long-term treatment of alopecia universalis," adds King. "The best available science suggested this might work, and it has."
After two months on tofacitinib at 10 mg daily, the patient's psoriasis showed some improvement, and the man had grown scalp and facial hair; the first hair he had grown there in seven years.
After three more months of therapy at 15 mg daily, the patient had completely regrown scalp hair and also had clearly visible eyebrows, eyelashes, and facial hair, as well as armpit and other hair, the doctors said.
Co-author Brittany G. Craiglow, M.D., says that there has been no reported side effects or test abnormalities.
A proposal has now been submitted for a clinical trial involving a cream form of tofacitinib, and it remains to be seen what further implications there may be.