After Chris Rock’s Misplaced Jada Pinkett Joke at the 2022 Oscar gala, the alopecia areata it has become a condition well known to the general public. However, before the viral slap in the face of Will Smith scientists knew full well what it was and tried to find treatments to alleviate it. In fact, that same Saturday they were published in The New England Journal of Medicine the results of a clinical trial in which the effectiveness against this type of alopecia of a drug usually used to fight against rheumatoid arthritis: the baricitinib.
In fact, both alopecia areata and rheumatoid arthritis are autoimmune diseases. That is, the patient’s immune system confuse and attacks the normal structures of his own body. In the case of arthritis, it turns against the joints, while with alopecia, those who suffer the consequences are the hair follicles, from which the hair grows. If there is no follicle, there is no hair.
Therefore, despite having very different symptoms, the origin of the two conditions is so similar that it could be treated with the same medicine. At least that’s what the leaders of this recent study, from Yale University, think. They decided to start a clinical trial, which has now completed its phase III with very good results, so that the treatment could soon also be available for alopecia. Who knows? maybe yours Jada Pinket could be treated with this substance.
Prevent the immune system from attacking what it shouldn’t
Baricitinib, marketed by the company Eli Lilly under the trade name Olumiantis an inhibitor of Janus Kinases. They are proteins involved in the regulation of gene expression in different body systems, including the immune.
We have seen that inhibitors of these proteins can dampens the immune responsewithout turning it off completely. This is useful for patients with autoimmune diseases, as they are not totally at the mercy of the pathogens, but the effects of this erroneous response from their defenses are reduced.
In rheumatoid arthritis it has already proven to be very useful. In fact, its use has been allowed to treat it for years. Therefore, the clinical tests intended to check its effects on another disease would go much faster than with a substance analyzed from scratch. After all, we already know how patients tolerate it. This has allowed fairly rapid progress in clinical trials for the alopecia areata treatment like the one suffered by Jada Pinkett.
From rheumatoid arthritis to alopecia areata
This clinical trial on a drug for alopecia areata brought together everything that is valued in these procedures. He was double-blind, randomized and placebo-controlled. That is, a randomly selected portion of the participants received a placebo that was completely indistinguishable from the real drug and neither they nor the staff who administered it knew which of the two options it was. It is the perfect method to check if a substance really has benefits beyond chance or patient suggestion.
In this specific case participated 1,200 people with alopecia areata, who were randomly assigned to three groups. Those in the first received the placebo, while the others received 2 milligrams or 4 milligrams of baricitinib.
All patients, regardless of the group to which they belonged, had a SALT score greater than 50. It is a tool used to assess the severity of alopecia. It ranges from 0, where there is no hair loss, to 100, which represents total hair loss. So they all had pretty serious alopecia areata.
However, 36 weeks later from the start of treatment 35% of those who received 4 milligrams of the rheumatoid arthritis drug had a score of 20 or less. In the case of those who took 2 milligramsthis SALT figure was reached in the twenty%. Therefore, the drug has proven effective against alopecia areata.
Is this medicine ready for people like Jada Pinkett?
The percentages obtained are a small breath of hope for people with alopecia areata, like Jada Pinkett. It is not a panacea, because it is only a third they would recover as best they could. Still, it’s better than nothing. However, it will still be necessary to wait for this new utility to be given to pharmacies.
It is important to consider your safety, which has not been bad. Yes, there were side effects, like acne, headaches or increased cholesterol levels. Additionally, by weakening the immune system, some patients have experienced respiratory or urinary infections, among others. However, it also happens to those who receive the drug for rheumatoid arthritis. Moreover, no patient stopped treatment because of these symptoms, so it seems that they were manageable.
Ultimately, the results of the phase III clinical trial encourage optimism that this drug will be approved for alopecia areata. But now, we will have to wait for the necessary authorizations to be requested from the competent authorities, whether the FDA in the United States, the EMA in Europe or any other. Once authorization has been requested, these authorities should review all documentation and clinical trial results and, if they deem it correct, give the green light. It takes time, so for now only patients with rheumatoid arthritis will be able to take this drug.
Jada Pinkett and everyone else with alopecia areata will have to keep hoping for treatment soon. A hope so great that one day they will stop making dirty jokes about their physique.