Keep in mind that I am new to learning this stuff myself. And I pick up things from various web sites after reading quickly, but I am fairly certain that the word "trials" for topical tofacitinib to treat hair loss disorders in general are currently underway. As people have said here, there is a lot of money at stake with a cure for pattern baldness. They are surely testing for that right now as it takes time to observe results and produce data in order to warrant further studies and eventually a product and approval. Everyone is fully aware that money and profit are ultimately driving these studies. Everyone has bills to pay including researchers, themselves driven by commitments to medicine and compassion for people, and the people funding them.
So they are taking the scientific approach. This really is the best way because if it turns out that JAK inhibitors do not solve pattern baldness, they will at least have more understanding of the pathways that actually affect hair growth and possibly leading them to an effective treatment.
There are all kinds of unknowns that will be answered with experiments currently underway. Of course the most direct answer to our questions will surely be known after pilot studies of topical tof applied directly to a small area of scalp affected by Androgenetic Alopecia. Every engineering professional knows that if you find one leak in a water hose or electrical path, you plug that leak or splice that wire and test it right away for a working path not continue on down the line looking for more leaks or breaks in the line which may or may not exist. A lot can be learnt from testing and trial and error which are valid methods of inquiry.
And now I think that it is not just normal mice with normal hair used in all experiments. Apparently Christiano's colleagues have done experiments on mice with alopecia areata-affected skin tissue grafted on the backs. They want to know more about an into an auto-immune disease affecting the skin and scalp referred to as
CANDLE which results in hair loss and skin lesions.
Topical Tofacitinib (for atopic dermatitis) success at Phase II Clinical July 2015
Ruxolitinib Cream Restores Hair Growth in Yale Study
So in these instances, when hair follicles enter resting state due to auto-immune attack, topical Ruxolitinib and Toficitinib are shown to be effective in re-growing hair. And that is a fairly extreme situation when the body's immune cells turn against hair follicles stopping growth. Could it be that the drug works regardless of what causes follicles to enter resting state? Similarly, people and animals can be tired and fall asleep by a number of causes such as a normal sleep-wake cycle, sleep deprivation, drug-induced sleep, anesthesia etc or an extreme situation like carbon monoxide poisoning. And the "cure" is generally the same for all of those conditions: oxygen and rest.
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By what I've read, physicians certainly can prescribe it off-label. The problem is the cost of the drug - it's expensive. The good news, according to Christiano, is that there are 2 oral JAK inhibitors with established safety records already approved, and that there are several more in the pipeline. I believe she means that if more JAK inhibitors come to market, prices will eventually drop. And, she says, there are all kinds of incentives for drug companies to pursue JAK-inhibitors/drugs because there will be several indications for the drug, like plaque psoriasis, rheumatoid arthritis and, in all likelihood, alopecia areata, A, AU and AT and possibly Androgenetic Alopecia.
Christiano also mentioned that buried deep within the paper she and Jahoda published is a method for delivering JAK inhibitors deep enough into the dermis for optimal effect by applying JAK-I to DP cells which are cultured in 3D spheres. When they did this, it increased induction and DP signaling by anywhere from 25% to 50% resulting in much more hair growth in, I believe, mice. So if any physician-prescribed versions of the compound do not work for Androgenetic Alopecia the same as it has for the other three hair loss disorders, I think there might still be success with Christiano's and Jahoda's invention which will have to be tested in registered clinical trials for several reasons and a patent being one of them.
I also gather that Christiano is hopeful for other drugs in the pipeline namely setipiprant.