Success for a new treatment for the disease that causes baldness

Success for a new treatment for the disease that causes baldness

2023-05-28 13:00:00

The 2022 Academy Awards ceremony will be remembered above all not for its winners and losers, but for The dramatic event which happened precisely in the entertainment part of the evening. In response to a bad taste joke by the host of the ceremony, the comedian Chris Rock, about the shaved head of the actress Jada Pinkett-Smith, her husband, the star Will Smith, came on stage and forcefully slapped Rock in the face. Smith later explained that he had lost his temper and reacted with violence inappropriate to an insult to his wife, who suffers from the skin disease Alopecia areata (Alopecia areata) which is expressed in local baldness in the hair.

There are those who underestimate the impact of skin diseases on the lives of the people who suffer from them, and treat them as a cosmetic problem and nothing more. But alopecia areata, called in Hebrew “area baldness”, often takes a heavy mental and social toll on the patients and severely damages their quality of life and self-esteem.

Patients suffer from sudden shedding of scalp hair, facial hair – eyebrows or beard, and more rarely body hair. The cause of this is an autoimmune disease – a condition in which cells of the immune system mistakenly attack normal cells of the body itself. In patients with alopecia areata, the target of the attack is the hair follicles in the skin, from which hairs grow. As a result, the hair falls out and small bald spots the size of a coin are formed, which may sometimes spread over wide areas of the scalp or beard. The disease is quite common and affects two percent of the population, regardless of gender. It can appear at any age, but tends to erupt at a young age: on average, in three out of every five patients it Break out before the age of 20and another one will strike her in the early matriculation years before the age of 40.

The damage to the follicle is reversible, since despite the shedding the follicle itself remains alive and may over time grow a new hair. Indeed, usually the hair grows back on its own within about a year and the bald area disappears. But the disease itself has no cure and may attack again even areas that have recovered.

Although it is a particularly common autoimmune disease, the processes that cause it are not sufficiently understood And the treatments available are inadequate. treatments in corticosteroids By mouth, by injection or local treatments, such as ointments, suppress the activity of the immune system and reduce the inflammatory response. Other ointments stimulate the recovery of the hair in the balding area, and in severe cases we also use ointments whose function is to reboot the immune system so that it stops attacking the hair follicles. However, in moderate or severe cases their effectiveness is limited and they have disturbing side effects.

The cells of the immune system attack the hair follicles in the skin. A person suffering from alopecia areata Alex Papp, Shutterstock

a new drug

Currently no treatment Has not received full approval from the Food and Drug Administration of the United States (FDA). In 2022, the drug baricitinib, based on weakening the inflammatory response in the body, was first approved by the FDA and the European Health Agency, but this approval was also limited to adults suffering from a serious disease.

The third and decisive phase of a clinical trial of the new drug Ritlecitinib has now been successfully completed. The experiment, funded by the pharmaceutical company Pfizer, Described in detail in the article Published in the journal The Lancet. The drug disrupts the activity of proteins that are important for the functioning of the immune system cells that attack the hair follicles. The study aims to examine how well the drug helps patients and to identify its main side effects, with the aim of evaluating its effectiveness and safety in several doses.

The trial encompassed 118 hospitals and clinics in 18 countries and included a total of 718 alopecia areata patients aged 12 and over who suffered from the loss of at least 50 percent of their scalp hair. Over a hundred of them were girls and boys aged 12-17.

The patients were randomly divided into several groups that differed from each other in the doses they received throughout the 48 weeks of the experiment. For the control, two groups were given a dummy treatment (placebo) for 24 weeks, and then two different doses of the real drug for the remaining 24 weeks. It was found that the longer the treatment lasted and the higher the dose, the better the results. Halfway through the trial period, 31 percent of patients receiving the highest dose experienced full or nearly full scalp regrowth compared to only two percent in the control groups. At the end of the second half of the treatment, the proportion of patients in the first group whose hair was restored increased to 40 percent.

Healthy hair follicles (above) and damaged hair follicles in alopecia areata (below) | Alila Medical Media, Shuttestock

Encouraging findings

In terms of the drug’s safety, most participants suffered from mild to moderate side effects, such as upper respiratory infections and headaches. No patient has been recorded to have suffered significant side effects such as heart attacks, infections or death. The trial findings are encouraging and indicate that the use of ritalcitinib in patients with localized baldness is an effective and safe treatment for both adults and adolescents.

The lead author of the article is Brett King (King), specified because “this research greatly advances the treatment of alopecia areata patients, since the clinical trial also included adolescents and the disease often affects children and teenagers as well. Therefore, this is a safe and effective drug for the treatment of young patients. The disease causes enormous suffering, for adults and children alike. It’s hard enough as it is To be a boy, and even more so a boy with big bald spots, maybe without an eyebrow, or without hair at all.”

Research on the drug continues, and now the researchers are testing the long-term effects of the treatment. The encouraging findings of the current trial significantly increase the likelihood that the drug will provide a good response to patients with alopecia areata in the future, including the young ones, who pay a particularly heavy social price for their disease.

#Success #treatment #disease #baldness


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