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What an exciting time in the world of hair loss! We have new JAK inhibitors for alopecia areata & drugs for androgenetic alopecia are on the way.<\/p>\n
In my view, new drugs need to earn their place as top options.<\/p>\n
When a new drug enters clinical practice, I think about how the drug fits into my practice in 4 steps. These are my ABCD\u2019s: Amazement, Benchmarking, Comparison, and Durability.<\/p>\n
Step 1: Amazement. When new drug is announced in the media there is real amazement about its potential. The trial results are impressive, but enthusiasm needs to be tempered by recognition that experience is limited. I approach all new data quite cautiously.<\/p>\n
Step 2: Benchmarking. For every new treatment that is launched to the world, the hard work for me comes when I begin comparing the drug\u2019s efficacy and safety with data from studies of existing therapies. These are often indirect comparisons, but they help determine whether the drug offers meaningful advantages. Is there reason to believe the new drug is truly better than my old ones?<\/p>\n
Step 3: Comparison. Stronger evidence emerges from direct comparative studies. Ideally what I want to see are good studies directly comparing the new drug with established therapies. These studies provide a clearer understanding of relative efficacy and safety and help define where the drug belongs in our treatment algorithms. I don\u2019t just want to guess if the new drug is better than the old, I want to see the two drugs side by side in the same trial. These sorts of studies are full of surprises. Sometimes we see a new drug is much better than old ones- but sometimes we see it is not.<\/p>\n
Step 4: Durability. Finally, if a drug is going to need to be used long term, then I want to see how it does long term! Am I really that excited about a 24 week study if my patient will need the drug 24 years? Step 4 is about durability and years of experience tell us about sustained effectiveness, long-term safety, rare adverse events. Studies of pharmacovigilance are part of step 4. Many surprises are found in step 4!<\/p>\n
Many exciting new drugs are currently in Stages 1 or 2. Ultimately, Stages 3 and 4 will determine their enduring place in clinical practice.<\/p>\n<\/div>\n