I have received a lot of interest from others on here in my involvement with the Xeljanz trials at Yale.

I thought it would be nice for everyone if I documented my progress on here. 

Xeljanz is a Jak3 inhibitor and is believed to work with alopecia by turning off the distress signal relayed by the hair follicle to the attacking immune system which is the cause of the hairs falling out. Xeljanz comes in a strength of 5mg per pill and a full box contains 60 tablets. The recommended dosage for arthritis is 1 tablet in the morning and another in the evening each day.

The trial is set in a series of stages and there are requirements before participating. These include monthly visits and blood tests every 2 weeks. Dr Brett King is absolutely fantastic and is an inspiration to me. His positivity and enthusiasm gives me the much needed hope I have craved for over a decade. I have been put on a low dose to start with which is 1 tablet every other day. My dosage has now been increased to 1 tablet every day and next month it could be increased to 2 tablets per day depending on the results. 

I have completed my first month and have already noticed my alopecia has stabilised . I have not lost any existing hairs. In addition to this I have seen little hairs growing in my chest area as well as eyebrows. Fingers crossed! To date, I have experienced no side effects.

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AW:  Other discussions on Xeljanz / Tofacitinib

https://alopeciaworld.com/main/search/search?q=Tofacitinib

 

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Hi Singh 

Im struggling to find a doctor willing to support this too 

Hi Singh 

did you know about the dr -

caiterina Ryan in Dublin who is supportive. ? Also what cotherspy  are you trying ?

the is ! 

Hi guys

New to this site but very impressed with the thread - took me a while to read. I'm after some stats :) - how long does one normally expect to wait to see some results? I had developed AU very rapidly last year, took me a while and a lot of $$$$ spent on useless treatments to finally find a doctor who knew about tofacitinib and was willing to prescribe. However, taking it since Jan this year and NOTHING! I started with 10 mg but later switched to 15 mg and now 20 mg of the generic, I am also receiving shots into my eyebrows and after the shots some hairs pop out, but not for long.. I also have some tiny patches of hair on my head now, but o think it's also due to injections..  know it's a long waiting game but since it's been around 6 months I feel a little discouraged...

Hi Kate, 

Welcome to the forum and your new family.

If your AU was very rapid and recent, it sounds like your immune system may still be in aggressive mode. It's promising that you're getting some regrowth from injections. How long have you been on 20mg? It can take up to a year to see results and really varies individually. Being patient sometimes feels more difficult than regrowing hair. 

You can ask your doc to consider adding 5mg oral minoxidil daily in conjunction with the 20mg Tofacitinib for 3-6 months and see if things improve.     

   

Hi

Thanks for your reply and sorry for taking so long to get back. I have only been on 20 mg for about a month, bit continue to lose eyelashes slowly. To be honest, hair is smth you can get used to but not having lashes and eyebrows sucks! My doctor is against minoxidil as he thinks it leads to heart issues bit I will talk to him about it. 

 Hi Kate, welcome to the thread, though I’m sorry alopecia lead you here. Stats around response are kindof hard to find, I took heart at the beginning of my journey in a study which showed a guy who didn’t respond for 8 months (like not even vellus hairs), at 18 months had 90% back. I need to dig up that paper again. I do think studies are conservative with response times. When I started in 2017 there were studies that only went for 3 months and then claimed response rate was pretty low.... many of us take much longer to see a result. Luckily more and more studies are of a longer timeframe and allow for co-therapies, however the strict guidelines around many medical studies can limit results and not give a great picture of results of someone who is throwing everything at the alopecia. My personal experience - 4 months I had very little to show, I upped my dose to 20 mgs and added a steroid pulse of betamethasone 5 mgs 2 days a week (must be two days together) and by 5 months success- vellus hair! Once growth was established I weaned off the betamethasone (pulsed for around 3 months) and luckily kept it all, though am still usually on 20 mgs (dropping at the moment for a minor surgery). I have 100% back. Besides the betamethasone I found some co therapies may have helped (but I can’t confirm as I used them all at once)- minoxidil (topical), lattise on lashes and brows, biotin supplement, vitamin d and iron (as determined by blood tests - d and iron I can be a bit low). The other thing and this is controversial, but berberine is a natural Jak 2 inhibitor and current research suggest Jak 2 inhibitors are slightly more effective than Jak 3 inhibitors (tofa mainly targets 1 and 3, Ruxo and baricitinib focus more on 1 and 2), so while I don’t think berberine is strong enough to do much on its own it may help a little bit as a cotherapy. I was taking this until recently as it’s a blood thinner and have to be off these for my surgery, but will continue once recovered. Unfortunately there are a few who don’t respond but if you are seeing some growth with shots I think it’s a matter of time and co therapies to see more growth.

Frida

hi frida you're right i also read for non-responders or incompetent regrowth that he tested the jakavi with the lowest dose on the 8 patient 5 had a complete regrowth,
i wonder if baracitinib would react like that it's also an inhibitor jak 1.2 you really know the difference between the two?

I can tried xeljanz and baricitinib 10 mg and 2mg of baricitinib as you say, but you think it can have a bad action on health? both simultaneously? I see my dermatologist Tuesday I ask him the question I thank you.

Hi Kevin, make sure you check with your dermatologist first. My theory is very much only a theory. It just seems baricitinib hasn’t had the alopecia studies of jakavi or Tofacitinib but I know trials are happening on it. The problem is these trials can literally take forever to get info out. 

I have a easy to read article that compares the two- unfortunately it’s in English  so not so easy to translate and the focus is RA but there’s a great simple chart that lists the specific interluekins and Stats that are targeted and differ between the two. I think the differences in what the inhibit are relevant in why Jak 2 suppression has slightly higher success than Jak 3. 

psb.1635.pdf

i do note however I am not a chemist or pharmacist so I read a lot and try my best to understand the science but sometimes the science does overwhelm me as I’m more of a humanities minded person- but I’ve learned with alopecia - you got to do the best you can to figure things out as there isn’t a great push behind research for us.

Hey Frida, as usual you are such a wealth of information, thank you.  I have a question on the berberine, where did you order or buy from and did you talk about it with a professional first or just go for it?  I’m thinking I’m going to give this supplement a try, so I was jw as I’ve never heard of this.  Thanks!

Lindsay

Hi Lindsay, buying supplements is a bit of a shot in the dark so I just tend to go for iherb ones or piping rock as expensive supplements are often no better then cheap ones (case in point beacon generic $15 for 30 vs Pfizer - thousands!) I don’t think the Jak 2 effect is terribly strong but it might just help that little bit. It’s a blood thinner too so could offset the blood clot risk but just be aware if you need to come off blood thinners for a medical reason that it does thin blood too (supplements are often missed and can led to issues in surgeries etc). There’s some good info online- I think the effect is modest but has helped treat diabetes too (which seems to sometimes have an autoimmune nexus). 

Herenis is a paper that is very science heavy and not about alopecia (of course - sigh)read the last paragraph before the bibliography for further details. Note Berberine is also a Jak 3 inhibitor! 

Berberinehydrochlorideinhibitscellproliferation.pdf

Hi Frida, how are u?

could you please show what berberine do you take? And how many you take it for a day? Tks!

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