According to REACH Market Research, dermatologists agree that Frontal Fibrosing Alopecia (FFA) is generally more difficult to treat, and less likely to have an optimal response to treatment than Alopecia Areata (AA).

NEWTON, Mass., Feb. 22, 2023 /PRNewswire/ — Since the June 2022 approval of Eli Lilly’s Olumiant (baricitinib), the AA market landscape has been dynamic with two more oral JAK inhibitors (e.g., Pfizer’s ritlecitinib and SUN/Concert Pharmaceutical’s deuruxolitinib) likely to be approved in the next year. In contrast, there is no FDA-approved treatment for FFA, a rare hair loss condition with a high clinical and psychosocial burden marked by frontal hairline recession and inflammation causing itching, pain, and burning.

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Currently, FFA patients are managed primarily with off-label:

  • Corticosteroids
  • JAK inhibitors
  • Non-steroidal immunosuppressants

However, JAK inhibitor use is not widespread (<10% of patients) mostly due to insurance restrictions. Physicians are eager for treatment options indicated specifically for FFA able to achieve complete response defined as stopping hair loss and inflammatory progression of the disease. Currently, about half of all patients achieve this goal, as one interviewed dermatologist states: “The condition will eventually burn out spontaneously, so we are preventing follicular loss in patients who are going to otherwise lose a lot of their hair permanently.”

Despite the high unmet need for effective treatments, the FFA pipeline is sparse, with few options under investigation including:

  • LEO Pharma’s topical pan-JAK delgocitinib
  • Pfizer’s TEC/JAK3 ritlecitinib through an investigator-initiated study

With no indication that Pfizer plans to apply for a label extension, there is opportunity for other pharmaceutical companies to develop treatments for FFA and own a significant share of the market.

Pooja Patel, Analyst at REACH: “With very few therapies in development for FFA, dermatologists will continue to rely upon off-label treatments. Although the first approved therapy will likely be a JAK inhibitor, dermatologists agree they would like to see more research into the pathophysiology of the disease to identify more druggable targets such as the IL-17/23 pathway, interferon gamma, and retinoic acid receptors.”

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