Upadacitinib shows significant hair regrowth in severe alopecia areata trials

Two phase 3 clinical trials, UP-AA1 and UP-AA2, have demonstrated that the JAK inhibitor upadacitinib can lead to substantial scalp hair regrowth in patients with severe alopecia areata. Results published in JAMA Dermatology indicate that approximately 54 to 55 percent of patients receiving the higher dose achieved at least 80 percent scalp coverage at 24 weeks.

The global, randomized, double-blinded studies enrolled adolescents (aged 12 to 17) and adults (under 64) with severe disease, defined by a Severity of Alopecia Tool (SALT) score of 50 or higher. Participants were randomized to receive either 15 mg, 30 mg of upadacitinib once daily, or a placebo.

While these results represent the upper end of reported efficacy for this class of drugs, upadacitinib is not yet approved for the treatment of alopecia areata. An application is currently under review by the FDA. Currently, ritlecitinib remains the only approved therapy for adolescent patients with the condition.