Experimental and early investigational drugs for androgenetic alopecia

ABSTRACT

Introduction: Treatments for androgenetic alopecia constitute a multi-billion-dollar industry, however, currently available therapeutic options have variable efficacy. Consequently, in recent years small biotechnology companies and academic research laboratories have begun to investigate new or improved treatment methods. Research and development approaches include improved formulations and modes of application for current drugs, new drug development, development of cell-based treatments, and medical devices for modulation of hair growth.

Areas covered: Here we review the essential pathways of androgenetic alopecia pathogenesis and collate the current and emerging therapeutic strategies using journal publications databases and clinical trials databases to gather information about active research on new treatments.

Expert opinion: We propose that topically applied medications, or intra-dermal injected or implanted materials, are preferable treatment modalities, minimizing side effect risks as compared to systemically applied treatments. Evidence in support of new treatments is limited. However, we suggest therapeutics which reverse the androgen-driven inhibition of hair follicle signaling pathways, such as prostaglandin analogs and antagonists, platelet-rich plasma (PRP), promotion of skin angiogenesis and perfusion, introduction of progenitor cells for hair regeneration, and more effective ways of transplanting hair, are the likely near future direction of androgenetic alopecia treatment development.

KEYWORDS:

• Androgenetic alopecia
• pathogenesis
• hair follicles
• treatment

Article highlights

• Androgenetic alopecia is a very common hair loss condition affecting roughly 50% of the adult population.

• The androgenetic alopecia disease mechanism is still relatively poorly understood, but involves a strong genetic contribution as well as some environmental input.

• Provision of treatments for androgenetic alopecia is already a multibillion dollar industry, though current therapeutic approaches have limited penetrance into the potential market.

• In the last 5 years, a rapid expansion in the commercial development of new and improved treatments has occurred.

• Multiple drug treatments are under pre-clinical development or are in clinical trials, as well as cell therapeutics and medical devices, and may be launched on the market in the near future.

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Declaration of interest

K. J. McElwee is Chief Scientific Officer for Replicel Life Sciences Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

The authors are funded by the Canadian Dermatology Foundation and Canadian Institutes of Health Research