Benjamin Franklin, one of the founding fathers of the US, famously joked that two things in life were certain: death and taxes.
For many men, however, a third inevitability looms – baldness.
In June, Pelage Pharmaceuticals announced “positive results” from Phase 2a clinical trials of PP405, a drug which aims to combat male-pattern baldness and the thinning of hair in women.
The drug is designed to “reactivate dormant hair follicle stem cells” and could become a “first-in-class” treatment for men and women, Pelage Pharmaceuticals said in a statement.
The treatment could “go beyond slowing the hair loss process and directly drive hair follicle regeneration,” said Dr Christina Weng, the company’s chief medical officer.
“This as a milestone that expands the possibilities of regenerative medicine,” she added. “As we advance into the next stage of clinical development, our focus remains on delivering a science-driven solution that works for everyone.”
Trial results show encouraging signs
The phase 2a trials involved 78 participants, both men and women – with each person applying the drug or a placebo to their scalp once a day for four weeks.
According to the results published by the company, four weeks after the treatment finished, an increase in hair density of 20 per cent or more was seen in almost one third of men who had a greater degree of hair loss. No improvement was observed in the placebo group.
Pelage Pharmaceuticals says what is particularly significant is the drug’s apparent ability to kick-start hair growth in follicles where no hair was previously present.
A new approach to hair regeneration
PP405 has been developed by researchers at the University of California, Los Angeles (UCLA), and targets a series of chemical reactions in cells. Male-pattern baldness is largely caused by genes, although environmental factors also play a role. In some men it begins in their late teens, with rates increasing with age.
A US study found that 16 per cent of men aged 18 to 29 had “moderate to extensive” hair loss, while among 40-somethings the figure was 53 per cent. Over their lifetime, 80 per cent of men will experience hair loss.
Also, about 40 per cent of women will be affected by a thinning of their hair cover.
Dr Bharat Pankhania, a senior clinical lecturer at the University of Exeter Medical School, said that with respect to medication, “some progress” had been made with male-pattern baldness.
“It’s inducing the hair follicles to be stimulated to wake up and start doing things they used to do once upon a time,” he said.
A true cure, however, remains elusive. Indeed a 2023 paper in Trends in Biotechnology said that the most effective treatment remained a hair transplant.
This paper noted that “the needs and expectations of patients” were typically not met by current drug treatments, which were often expensive and had limited effectiveness.
According to the study, only two drugs approved by the US Food and Drug Administration have been marketed as treatments following four decades of research – and these were branded as being only “marginally effective”.
A lucrative market driving innovation
According to figures quoted in the Trends in Biotechnology paper, the global alopecia market was worth $7.6 billion in 2020, and by 2028 is likely to reach $13 billion. Some estimates have put the sector’s value as being even higher.
“Because it’s a huge market there’s a lot of research to find a solution,” Dr Pankhania said. “I remain optimistic, just as I remain optimistic with the management of [other conditions including] sickle cell anaemia. There’s a demand.”
While PP405 has sparked many headlines, there are many other strands of research aimed at gaining a better understanding of male-pattern baldness in the hope of finding a cure. Much of this centres on the genetic basis for the condition.
Research by the University of Bonn and other institutions in Germany, published in 2023, found a link between rare variants of five genes and male-pattern baldness. The results, the university said when its findings were released, could lead to improved treatments.
So for those whose hair is thinning or has almost completely gone, there are causes for optimism – assuming, of course, that they feel that their baldness needs to be cured.
