Two phase 3 trials, UP-AA1 and UP-AA2, have found that upadacitinib, an oral JAK inhibitor already used for conditions including rheumatoid arthritis and atopic dermatitis, produced significant scalp hair regrowth in patients with severe alopecia areata, according to results published in JAMA Dermatology.
The global, double-blind, placebo-controlled study randomised 1,399 adults and adolescents (aged 12 to 64, weighing at least 30kg) with severe alopecia areata, whose scalp hair loss averaged over 80 per cent, to once-daily upadacitinib 15mg, 30mg, or placebo.
At week 24, 44.6 to 45.2 per cent of patients on the 15mg dose and 54.3 to 55.0 per cent on the 30mg dose achieved at least 80 per cent scalp hair coverage, compared with just 1.5 to 3.4 per cent on placebo (p<0.001 for both doses in both trials), with benefit visible from week 8, researchers said.
Around a fifth of patients on the higher dose achieved complete scalp regrowth. Eyebrow, eyelash and quality-of-life measures also improved.
Adverse events were broadly consistent with upadacitinib's known safety profile, with acne, nasopharyngitis and respiratory infections most common.
The EU approved upadacitinib for severe alopecia areata in July 2026 (AbbVie, Rinvoq).
