Upadacitinib for Severe Alopecia Areata in Adults and Adolescents: Two Phase 3 UP-AA Randomized Clinical Trials.

What was studied

This study tested upadacitinib, a pill, in people with severe alopecia areata. In this disease, hair falls out but leaves no scars. There were 2 trials of the same design, run at the same time. In total, 1399 people aged 12 to 64 took part. People were put by chance into one of 3 groups. Groups took the drug at 15 mg or 30 mg each day. The other group took a dummy pill. For 24 weeks, neither people nor staff knew who got which.

What they found

The main goal was a hair loss score of 20 or less. This was checked at week 24. In the 15 mg groups, 122 and 129 people reached this goal. In the 30 mg groups, 149 and 157 people reached it. In the dummy pill groups, 2 and 5 people did. Both drug doses did better than the dummy pill. Common side effects included nose and throat germs and acne. Some people had a raised level of a blood enzyme. Grave side effects hit 9 people on 15 mg and 13 on 30 mg. On the dummy pill, 1 person had one. No new safety issues were found.

What it means for patients

The authors say the gains of the drug seem larger than its harms. They say this holds for both adults and teens with severe disease. In their view, upadacitinib may work as a way to treat these people. Side effects in both age groups were alike, the abstract says.

Why it is not certain yet

The main results come from the first 24 weeks only. The abstract does not give results from the later 28-week part. The abstract does not give gains for teens and adults on their own. Only people aged 12 to 64 with severe hair loss took part. The abstract does not say how long new hair stays.

Source

Upadacitinib for Severe Alopecia Areata in Adults and Adolescents: Two Phase 3 UP-AA Randomized Clinical Trials.

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