Upadacitinib Drives Robust Hair Regrowth in Adolescents and Adults With Severe Alopecia Areata
A subgroup analysis from the phase 3 UP-AA clinical program demonstrates that upadacitinib significantly improves scalp and facial hair regrowth in both adolescents and adults with severe alopecia areata (AA), with a safety profile consistent with prior studies. Prior phase 3 trials established efficacy of upadacitinib, and this analysis aimed to further evaluate outcomes across adolescent and adult populations.
Patients aged 12 to 63 years with severe AA (Severity of Alopecia Tool [SALT] score ≥50) were randomized to placebo, upadacitinib 15 mg once daily, or upadacitinib 30 mg once daily. The primary endpoint was achieving a SALT score ≤20 at week 24, with additional endpoints including complete or near-complete scalp regrowth (SALT ≤10 or SALT 0) and eyebrow/eyelash regrowth.
At week 24, significantly higher proportions of both adolescents and adults treated with upadacitinib achieved SALT ≤20 compared with placebo. In adolescents, response rates reached as high as 84.6% with the 30 mg dose, compared with 0% to 10% in placebo groups. In adults, approximately 44% to 52% of patients achieved SALT ≤20 with upadacitinib vs minimal responses in placebo groups. Additional endpoints showed consistent improvement, with higher rates of SALT ≤10, SALT 0, and eyebrow and eyelash regrowth across both age groups.
Safety findings were favorable and no serious adverse events occurred in adolescent populations. Rates of adverse events of special interest, including malignancy, opportunistic infections, and major cardiovascular events, were low.
“Upadacitinib 15 and 30 mg demonstrated high degrees of efficacy for regrowth of scalp and facial hair through 24 weeks in adolescents and adults with severe AA,” the authors concluded. “Safety findings were generally consistent with the known profile for upadacitinib, and no new safety signals were identified in either study.”
These findings support upadacitinib as an effective systemic option for severe AA across age groups, with meaningful improvements in both clinical and patient-reported outcomes.
Reference
Gooderham M, Passeron T, Kwon O, et al. Efficacy and safety of upadacitinib in adolescents and adults with severe alopecia areata: a subgroup analysis of the UP-AA phase 3 clinical program. Presented at: American Academy of Dermatology Annual Meeting; March 27–31, 2026; Denver, Colorado.
