1 of 2 | Fine light hairs called vellus hairs appear on the scalp of a patient with alopecia totalis six weeks after she began dupilumab treatment for eczema. Photos courtesy of Massachusetts General Hospital
Oct. 10 (UPI) -- A drug approved to treat moderate to severe eczema significantly restored hair growth in a young patient with alopecia -- the first known case of the link.
Massachusetts General Hospital reported that a 13-year-old patient with alopecia totalis -- a total lack of scalp hair -- was being treated with dupilumab, a drug marketed under the brand name Dupixent, for eczema and had the unexpected side effect. The findings, which were published Wednesday in JAMA Dermatology.
About 80 million men and women in the United States have this type of hair loss, according to the American Academy of Dermatology. The most common cause is hereditary, but other causes include stress, disease, medical treatment and giving birth.
"We were quite surprised since this patient hadn't grown scalp hair since the age of 2, and other treatments that can help with hair loss did not in her case," senior author Dr. Maryanne Makredes Senna, a principal investigator at the Hair Academic Innovative Research -- HAIR -- clinical research unit at MGH and an instructor in dermatology at Harvard Medical School, said in a press release. "As far as we know, this is the first report of hair regrowth with dupilumab in a patient with any degree of alopecia areata."
The patient also had experienced extensive, treatment-resistant eczema since the age of 7 months, researchers said.
She previously was treated with prednisone and methotrexate that led to limited improvement in her eczema, but no hair regrowth. She discontinued taking the drugs, which can suppress the overactive immune system.
In July 2017, the patient began treatment with weekly injections of dupilumab, which had recently been approved by the Federal Drug Administration, and is sold by Regeneron Pharmaceuticals and Sanofi Genzyme under the brand name Dupixent.
After six weeks of treatment, she not only had significant improvement in eczema symptoms, but noticed that fine light hairs called vellus hairs were appearing on her scalp.
Because of a change in her insurance coverage, she discontinued dupilumab for a two-month period, during which she noticed shedding of the recently regrown hair. After she resumed treatment last April, the hair growth resumed and has continued.
The drug costs about $3,000 a month, according to GoodRx.
Senna said dupilumab's mechanism targeting a key immune system pathway known to be overactive in eczema could explain its work against alopecia. She noted recent studies have suggested other elements of the same pathway may induce autoimmune hair loss.
"Right now, it's hard to know whether dupilumab could induce hair growth in other alopecia patients, but I suspect it may be helpful in patients with extensive active eczema and active alopecia areata," she said.
Senna has submitted a proposal for a clinical trial using dupilumab in order to further investigate its hair regrowth potential.
