Arthritis Drug Upadacitinib Shows Strong Results for Severe Alopecia Areata

Two Phase 3 clinical trials published in JAMA Dermatology in August 2026 found that upadacitinib, an oral drug already approved for rheumatoid arthritis, produced significant hair regrowth in adults and adolescents with severe alopecia areata.

The trials, known as UP-AA1 and UP-AA2, enrolled nearly 1,400 participants who had lost at least 50 percent of their scalp hair. Participants received either 15 mg or 30 mg of upadacitinib daily, or a placebo, for 24 weeks.

Results showed that about 45 percent of patients on the 15 mg dose and 54 to 55 percent of patients on the 30 mg dose achieved at least 80 percent scalp hair coverage. In the placebo group, only 1 to 3 percent reached that threshold. Complete scalp regrowth was observed in roughly 13 percent of the lower-dose group and 23 percent of the higher-dose group.

Patients also reported regrowth of eyebrows and eyelashes, along with improvements in emotional and social quality-of-life scores. Hair regrowth began appearing as early as eight weeks into treatment.

Upadacitinib works by blocking the JAK/STAT signaling pathway, which drives the immune response that attacks hair follicles in alopecia areata. The drug is sold under the brand name Rinvoq and is manufactured by AbbVie.

The drug has already received regulatory approval for alopecia areata in the European Union. In the United States, the FDA is currently reviewing it for this indication. Until formal approval is granted, U.S. physicians may prescribe it off-label.

Common side effects in the trials included upper respiratory infections, acne, and elevated creatine phosphokinase levels.