Upadacitinib is associated with fast hair regrowth and significant improvement in quality of life among patients with alopecia areata (AA), according to a research letter published in Journal of the American Academy of Dermatology.
Researchers conducted a retrospective cohort study and enrolled patients with AA from October 2021 to July 2022. All participants received monotherapy with the Janus kinase (JAK) inhibitor upadacitinib.
Outcomes were measured with the Severity of Alopecia Tool (SALT) and Dermatology Life Quality Index (DLQI).
A total of 25 participants (median age, 31 years; 72% women) were included, of whom 4 had a history of atopic dermatitis (16%). Upadacitinib therapy was initiated at 15 mg per day, and 3 participants increased to 30 mg after 4 weeks. The participants did not use adjunctive therapy such as minoxidil or intralesional triamcinolone in the first 24 weeks of therapy.
After 12 weeks of treatment, the median absolute SALT scores decreased from 50 at baseline to 25 and further decreased at week 24 to a median of 5. Participants’ DLQI scores decreased from a median of 15 at baseline to 8 at week 12 and 2 at week 24. The participants also experienced more than 50% regrowth of eyelash and eyebrow hair.
No participants had clinically significant laboratory abnormalities or infectious complications during the first 24 weeks of treatment, and none discontinued treatment owing to adverse events. Nausea occurred in 2 patients (8%), and 1 patient had headache (4%), all of which spontaneously resolved after 4 weeks.
Limitations of the study include the small sample size, the absence of a placebo-controlled arm, short study duration, and the relatively young age of participants.
“Consistent with other JAK inhibitors such as baricitinib, our patients on upadacitinib saw rapid regrowth of hair and significant improvement in quality of life,” conclude the researchers. “Further evaluation in larger cohorts is necessary to compare the safety and efficacy of upadacitinib to other JAK inhibitors.”
Disclosure: One of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Flora A, Kozera E, Frew JW. Treatment of alopecia areata with the Janus kinase inhibitor upadacitinib: a retrospective cohort study. J Am Acad Dermatol. Published online February 15, 2023. doi:10.1016/j.jaad.2022.12.056