The podcast focused on emerging therapies for alopecia areata, an autoimmune condition causing non-scarring hair loss that commonly affects the scalp, beard, eyebrows, eyelashes, and body hair. The condition manifests in various forms, including patchy alopecia, alopecia totalis (complete scalp hair loss), and alopecia universalis (complete body and scalp hair loss). While its exact cause is unknown, autoimmune triggers, genetic predisposition, and association with other autoimmune conditions like thyroid disease and vitiligo are risk factors, and stress can worsen it. ...Current treatments for mild cases include topical corticosteroids and intralesional injections, while moderate to severe cases often require systemic corticosteroids or immunomodulators. The primary emerging therapies discussed are JAK inhibitors, which are enzymes involved in inflammation pathways; these inhibitors block the enzyme to reduce inflammation. Tofacitinib is currently used in India, starting at 5 mg and escalating up to 11 mg, with pre-treatment screening for infections, liver, and kidney function. Other FDA-approved JAK inhibitors specifically for alopecia include Baricitinib (Jack 1 and 2 inhibitor, approved 2022), Ritlecitinib (Jack 3 inhibitor, approved 2023), and Duroxilitinib (Jack 1 and 2 inhibitor, approved 2024). Beyond these, experimental therapies like microneedle patch therapy using pegylated hyaluronic acid needles with INQ2 are being explored in animal models and moving towards human trials. Other inhibitors such as Itacitinib (Jack 1) are in Phase 2 trials, and Equilium (EQ101), a pan-JAK inhibitor, is in Phase 1 and 2 trials. Given alopecia’s chronic and recurrent nature, particularly in extensive cases, a holistic approach involving medical treatment, psychological support, counselling, and support groups is vital for long-term management.
