Not Therapeutic Advances in Alopecia Areata...Alopecia Areata: Pathogenesis Divito SJ, Kupper TS....
16
Therapeutic Advances in Alopecia Areata Brett King, MD, PhD Associate Professor of Dermatology Yale University School of Medicine Not for Distribution
Transcript of Not Therapeutic Advances in Alopecia Areata...Alopecia Areata: Pathogenesis Divito SJ, Kupper TS....
Therapeutic Advances in Alopecia Areata
Brett King, MD, PhD
Associate Professor of Dermatology
Yale University School of Medicine
Not for Distribution
Disclosures
• Off-label use of medications will be discussed
• I have received honoraria and/or consulting fees from:Aclaris Therapeutics, Concert Pharmaceuticals, DermavantSciences, Eli Lilly, Pfizer
• I am a clinical trial investigator for:Concert Pharmaceuticals, Eli Lilly, Pfizer
• I am on a speaker bureau for:Pfizer, Regeneron, Sanofi Genzyme
Not for Distribution
Alopecia Areata: Treatment
• Intralesional corticosteroids
• Topical corticosteroids
• Topical immunotherapy (e.g. diphenylcyclopropenone, squaric acid)
• Topical minoxidil
• Oral corticosteroids
• Methotrexate
• Cyclosporine
* No reliably effective therapies, especially for severe disease
Strazzulla LC, et al. Alopecia areata: An appraisal of new treatment approaches and overview of current therapies. J Am Acad Dermatol. 2018;78(1):15-24.
Not for Distribution
Baseline 2 monthstofacitinib 5 mg BID
5 monthstofa 10 + 5 mg daily
8 monthstofa 10 + 5 mg daily
Not for Distribution
Ruxolitinib 20 mg BID
Nat Med. 2014;20(9):1043-9.
Not for Distribution
Alopecia Areata: Pathogenesis
Divito SJ, Kupper TS. Nat Med. 2014;20(9):989–90. Based on Xing L, et al. Nat Med. 2014;20(9):1043-9.
Not for Distribution
Cyt
oki
ne
Sign
alin
g is
Med
iate
d
by
JAK
-STA
T Pa
thw
ay
Janus kinase (JAK) family consists of JAK 1, JAK 2, JAK 3, and Tyrosine Kinase 2 Vitiligo
cytokine: IFN-g
JAK 1/2
AA
cytokines:
IL-15, IFN-g
JAK 1/2/3
JAK inhibitorJAK inhibitor
Damsky W, King BA. J Am Acad Dermatol. 2017;76(4):736-744.
AD
cytokines: IL-4, IL-13
JAK 1/3
Not for Distribution
J A
m A
cad
Der
mat
ol.
20
17
;76
(1):
22-
28.
J A
m A
cad
Der
mat
ol.
20
17
;76
(1):
29-
32.
J A
m A
cad
Der
mat
ol.
20
19
;80
(2):
568
-9.
Brittany G. Craiglow, MD, and Brett A. King, MD, PhD
New Haven, Connecticut
J A
m A
cad
Der
mat
ol.
20
19
;80
(2):
566
-8.
Lucy Y. Liu, MD, and Brett A. King, MD, PhD
New Haven, Connecticut
J A
mA
cad
Der
mat
ol.
20
18
;78
(2):
403
-4.
Not for Distribution
JAKi in AA: Clinical Trials
JAK INHIBITOR TARGETROUTE OF ADMINISTRATION PHASE STATUS IDENTIFIER
ATI-501 JAK1/3 oral 2 active, not recruiting NCT03594227
ATI-502 JAK1/3 topical 2 not yet recruiting NCT03759340
baricitinib JAK1/3 oral 2/3 recruiting NCT03570749
CTP-543 JAK1/2 oral 2b/3 not yet recruiting NCT03811912
PF-06651600 JAK3 oral 2b/3 recruiting NCT03732807
Not for Distribution
Other Therapeutic Possibilities?
• Apremilast
• Ustekinumab
• Dupilumab
• Fecal transplant
Not for Distribution
Other Therapeutic Possibilities : ApremilastNot for Distribution
Other Therapeutic Possibilities: UstekinumabNot for Distribution
Other Therapeutic Possibilities: DupilumabNot for Distribution
Other Therapeutic Possibilities: Fecal TransplantNot for Distribution
The Future of AA Treatment
• JAK inhibitors
• Apremilast
• Ustekinumab
• Dupilumab
• Fecal transplant
• Other?
Not for Distribution
Thank you
Not for Distribution
![CASE OF ALOPECIA AREATA ORIGINATED FROM DENTAL FOCUS · like alopecia areata (Ormsby 1948, Roxburgh 1950), before progressing to development of lesions and sores. [18, 19, 20] Alopecia](https://static.fdocuments.in/doc/165x107/5c8baa0709d3f2016f8cacb0/case-of-alopecia-areata-originated-from-dental-focus-like-alopecia-areata-ormsby.jpg)