ClinicalTrials.gg
RecruitingNCT07734870Updated Nov 3, 2026

Tirzepatide for Treatment of CCCA

A Phase 2 interventional study of Tirzepatide in Central Centrifugal Cicatricial Alopecia (CCCA), sponsored by Johns Hopkins University. Recruiting at 2 sites in United States. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-11-03.

Sponsored by Johns Hopkins University · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Sep 2026; still recruiting 1 month later.
Phase
Phase 2
Study type
Interventional
Enrollment
20
Allocation
Not applicable
Ages
18 Years to 80 Years
Sex
All
01

Study summary

The goal of this pilot clinical trial is to learn if tirzepatide can treat active central centrifugal cicatricial alopecia (CCCA), a type of permanent scarring hair loss, in adults. The main questions it aims to answer are:

  • Does tirzepatide improve the symptoms and signs of active CCCA?
  • Does tirzepatide change the activity of genes in the scalp, especially genes related to scarring?
  • Does tirzepatide promote hair regrowth?

Participants will:

  • Inject tirzepatide once a week for 12 months.
  • Visit the clinic for scalp examinations, photographs, and other health assessments.
  • Have scalp biopsies at the beginning of the study and after 6 months of treatment.
  • Have blood tests and other safety monitoring during the study.

There is no separate comparison group. Researchers will compare each participant's results during treatment with the participant's results at the beginning of the study.

02

Conditions studied

  • Central Centrifugal Cicatricial Alopecia (CCCA)

Keywords

  • Scarring alopecia
  • Hair loss
  • Hair regrowth
  • Scalp fibrosis
  • Tirzepatide
  • Metabolic dysfunction
  • Insulin Resistance
  • Gene expression
03

In context

Alopecia

511 studies on the registry are indexed under Alopecia; 128 are open to participants now.

This study's planned enrollment of 20 is below the median of 50 across 430 interventional studies indexed under Alopecia.

Browse Alopecia studies →

Lead sponsor

Johns Hopkins University is the lead sponsor of 1,815 studies on the registry; 315 are open to participants now.

Of its 208 completed or terminated interventional studies of FDA-regulated products, 144 (69%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age 18 to 80 years.
  • Clinical and/or -confirmed diagnosis of central centrifugal cicatricial alopecia (CCCA).
  • Active CCCA, defined as a C-CAT disease activity score greater than 1.
  • No treatment for CCCA during the 6 weeks before enrollment.
  • Able and willing to complete the study and follow all study procedures.
  • Managed by a Johns Hopkins dermatologist throughout the study.

Exclusion criteria

Exclusion Criteria:

  • Currently taking an oral or systemic blood glucose-lowering medication.
  • Currently taking another medication for weight loss.
  • below 5.4%.
  • Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) score below 2.
  • below 19 kg/m².
  • Pregnant, breastfeeding, or planning a pregnancy.
  • Personal or family history of medullary thyroid cancer.
  • Personal or family history of multiple endocrine neoplasia type 2.
  • History of chronic kidney disease.
  • History of pancreatitis.
  • History of diabetic retinopathy.
  • Severe gastrointestinal disease.
  • Recent or planned major surgery.
  • Type 1 diabetes.
  • Any other to tirzepatide.
  • History of keloids or hypertrophic scarring.
  • History of poor wound healing.
  • History of a blood-clotting disorder.
  • Allergy to lidocaine or epinephrine.
  • Known sensitivity to local numbing medication.
  • Any significant medical condition that the investigator believes would make participation unsafe or prevent completion of the study.
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

HbA1c

A blood test of average blood sugar over the past two to three months, given as a percentage or in mmol/mol. 6.5% (48 mmol/mol) or more is the usual threshold for diabetes, normally confirmed by a second test.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
20 participants (estimated)

Study arms

  • Experimental
    Tirzepatide Treatment

    Participants will self-administer tirzepatide by subcutaneous injection once weekly for 12 months. Tirzepatide will be administered at 2.5 mg once weekly for the first 4 weeks, followed by 5 mg once weekly for the remainder of the study. Participants may use topical corticosteroids as needed for intolerable CCCA-related symptoms, such as scalp pain or itching.

    Drug: Tirzepatide

Interventions

  • Tirzepatide solution will be self-administered by subcutaneous injection once weekly. Participants will receive 2.5 mg once weekly for the first 4 weeks, followed by 5 mg once weekly for the remainder of the 12-month treatment period. Injection sites will be rotated among the abdomen, thigh, or upper arm.

    Also known as: Mounjaro, Zepbound, LY3298176

06

What researchers measure

Primary outcomes

  1. Change in Central Centrifugal Cicatricial Alopecia Clinical Activity Tool Score

    Disease activity will be measured using the Central Centrifugal Cicatricial Alopecia Clinical Activity Tool (C-CAT). The C-CAT assesses disease progression, scalp pain or tenderness, scalp itching, inflammation, and scalp fibrosis. Total scores range from 0 to 10, with higher scores indicating greater disease activity. Scores obtained during treatment will be compared with the baseline score.

    Time frame: Baseline, 3 months, 6 months

  2. Change in Scalp Gene-Expression Profiles

    Differential messenger RNA expression will be assessed using bulk RNA sequencing of paired scalp biopsies collected at baseline and 6 months of tirzepatide treatment. Differential expression will be defined as at least a two-fold change with an adjusted p-value less than 0.05. Analyses will focus on profibrotic and inflammatory pathways, including transforming growth factor beta, collagens 1, 3, and 6A1, and T-helper 17-related pathways.

    Time frame: Baseline, 6 months

Secondary outcomes

  1. Change in Central Hair Loss Grade

    Central scalp hair loss will be evaluated by physician raters using standardized clinical photographs and the Central Hair Loss Grade scale. Scores range from 0 to 5, with higher scores indicating more severe central hair loss. Scores obtained during treatment will be compared with the baseline score.

    Time frame: Baseline, 3 months, 6 months

  2. Physician Global Assessment of Change in Hair Loss

    Physician raters will compare standardized clinical photographs obtained at months 3 and 6 with baseline photographs. Change in hair loss will be evaluated using a 5-point physician global assessment scale. Score range 0 (None) - 4 (Very severe).

    Time frame: Baseline, 3 months, 6 months

07

Study locations

2 of 2 sites recruiting
  • Johns Hopkins Outpatient Center
    Baltimore, Maryland 21287, United States
    Recruiting
  • Medical Pavilion at Howard County
    Columbia, Maryland 21044, United States
    Recruiting
08

References and documents

Publications

  • Qadri A, Will E, Aguh C. Using Disease Symptomatology to Guide Treatment in Patients with Central Centrifugal Cicatricial Alopecia: Introduction of C-CAT Scoring Tool. Skin Appendage Disord. 2025 Aug;11(4):309-315. doi: 10.1159/000544777. Epub 2025 Feb 20. PubMed 40771443 ↗
  • Dina Y, Okoye GA, Aguh C. Association of Uterine Leiomyomas With Central Centrifugal Cicatricial Alopecia. JAMA Dermatol. 2018 Feb 1;154(2):213-214. doi: 10.1001/jamadermatol.2017.5163. PubMed 29282458 ↗
  • Loomba R, Hartman ML, Lawitz EJ, Vuppalanchi R, Boursier J, Bugianesi E, Yoneda M, Behling C, Cummings OW, Tang Y, Brouwers B, Robins DA, Nikooie A, Bunck MC, Haupt A, Sanyal AJ; SYNERGY-NASH Investigators. Tirzepatide for Metabolic Dysfunction-Associated Steatohepatitis with Liver Fibrosis. N Engl J Med. 2024 Jul 25;391(4):299-310. doi: 10.1056/NEJMoa2401943. Epub 2024 Jun 8. PubMed 38856224 ↗
  • Bao A, Qadri A, Gadre A, Will E, Collins D, Ahima R, Bordone LA, Aguh C. Low-Dose Metformin and Profibrotic Signature in Central Centrifugal Cicatricial Alopecia. JAMA Dermatol. 2024 Nov 1;160(11):1211-1219. doi: 10.1001/jamadermatol.2024.3062. PubMed 39230880 ↗
  • Tuleta I, Frangogiannis NG. Diabetic fibrosis. Biochim Biophys Acta Mol Basis Dis. 2021 Apr 1;1867(4):166044. doi: 10.1016/j.bbadis.2020.166044. Epub 2020 Dec 28. PubMed 33378699 ↗
  • Aguh C, Dina Y, Talbot CC Jr, Garza L. Fibroproliferative genes are preferentially expressed in central centrifugal cicatricial alopecia. J Am Acad Dermatol. 2018 Nov;79(5):904-912.e1. doi: 10.1016/j.jaad.2018.05.1257. Epub 2018 Jun 18. PubMed 29913259 ↗
  • Jamerson TA, Conover Talbot C Jr, Dina Y, Kwatra SG, Garza LA, Aguh C. Gene expression profiling suggests severe, extensive central centrifugal cicatricial alopecia may be both clinically and biologically distinct from limited disease subtypes. Exp Dermatol. 2022 May;31(5):789-793. doi: 10.1111/exd.14524. Epub 2022 Jan 20. PubMed 35007355 ↗
  • Roche FC, Harris J, Ogunleye T, Taylor SC. Association of type 2 diabetes with central centrifugal cicatricial alopecia: A follow-up study. J Am Acad Dermatol. 2022 Mar;86(3):661-662. doi: 10.1016/j.jaad.2021.02.036. Epub 2021 Feb 18. No abstract available. PubMed 33609590 ↗
  • Ogunleye TA, McMichael A, Olsen EA. Central centrifugal cicatricial alopecia: what has been achieved, current clues for future research. Dermatol Clin. 2014 Apr;32(2):173-81. doi: 10.1016/j.det.2013.12.005. Epub 2014 Jan 22. PubMed 24680004 ↗

Individual participant data

Plan to share: No — There is no current plan to share individual participant data because of privacy and confidentiality considerations associated with the study's small sample size, clinical scalp photographs, and transcriptomic data. Study findings may be reported in aggregate in scientific presentations and publications.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Sep 2026 (actual). Primary completion is estimated for May 2028, 20 months after the start.

Of 41 phase 2 interventional studies under Alopecia, half reached primary completion within 13 months of starting (the median), counting those still running; a quarter within 9 and three quarters within 24. This study's planned 20 months is above that.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 24, 2026
First posted
Jul 29, 2026
StartActual
Sep 15, 2026
Primary completionEst.
May 25, 2028
CompletionEst.
May 25, 2028
Last update
Nov 3, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Minor edits
Nothing that changes what the study is or who can join. Edited: verification date and date precision
1 update, last Nov 3, 2026
Show all 1 update
  1. Nov 3, 2026
    Minor edits only
    + 2 other changes: verification date and date precision

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07734870
Responsible party
Sponsor
First posted
Jul 29, 2026
Start date
Sep 15, 2026
Primary completion
May 25, 2028 (estimated)
Completion
May 25, 2028 (estimated)
Last update
Nov 3, 2026

Study contacts

Dakarai A Dunbar, BS
Contact
ddunbar7@jh.edu
4435976380
Crystal U Aguh, M.D.
Contact
cagi1@jhmi.edu
Crystal U Aguh, M.D.
principal investigator · The Johns Hopkins Department of Dermatology

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Interested in this study?

Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.

Contact study team

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Studies of the drug tested here: Tirzepatide

Start the discussion