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A widely used arthritis drug has shown promise as a treatment for severe alopecia areata, according to two large clinical trials that found it helped roughly half of participants regrow significant amounts of hair.
"These findings are very encouraging, particularly because this was not a small preliminary study," Dr. Keith Kantor, clinical director at Regen Therapeutics, a hair restoration clinic, told Newsweek. "We are looking at two large Phase 3 randomized trials involving nearly 1,400 adults and adolescents with severe alopecia areata.
"At 24 weeks, roughly 45 percent of patients receiving the 15-mg dose and about 54 to 55 percent receiving the 30-mg dose had 80 percent or more scalp hair coverage, compared with only about 1 to 3 percent of patients receiving placebo."
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Newsweek has contacted the study's lead author, Dr. Arash Mostaghimi, for comment via email.
What the Study Found
The trials, published in JAMA Dermatology, tested the drug upadacitinib, an oral medication already approved for conditions such as rheumatoid arthritis, in patients aged 12 to 64 with severe alopecia areata—an autoimmune condition that causes nonscarring hair loss, sometimes across the entire scalp, face and body.
Conducted between October 2023 and July 2025 at more than 237 clinical centers worldwide, the two studies randomly assigned participants to take 15 milligrams of upadacitinib, 30 milligrams, or a placebo once daily for 24 weeks. All participants had lost at least half their scalp hair, with an average baseline hair loss of nearly 84 percent.
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By week 24, 44.6 to 45.2 percent of patients on the lower dose and 54.3 to 55 percent on the higher dose had regained at least 80 percent of their scalp hair coverage.
Among placebo patients, only 1.5 to 3.4 percent reached that benchmark.
"Alopecia areata is not simply ordinary thinning or hereditary hair loss," Kantor said. "It is an autoimmune disease in which the immune system attacks the hair follicle. Upadacitinib is a JAK inhibitor, so rather than simply trying to stimulate the hair from the outside, it is targeting part of the immune signaling involved in the disease."
The drug belongs to a class known as Janus kinase, or JAK, inhibitors, which block immune pathways involved in the disease.
The trials also found improvements in eyebrow and eyelash regrowth, along with better scores on quality-of-life measures. Some patients achieved complete scalp regrowth.
Limits and Safety
Despite the promising report, Kantor cautioned against overstating the results.
"About half of the patients reached the primary scalp-hair endpoint at 24 weeks, which is excellent compared with placebo, but it also means that a substantial number did not," he said. "We also need longer-term information about durability of the response, what happens when treatment is stopped, and long-term safety."
The most common side effects—reported in more than 5 percent of patients in any group—included upper respiratory infections, acne, elevated creatine phosphokinase levels and nasopharyngitis. Serious adverse events occurred in 1.6 percent of patients on the lower dose, 2.3 percent on the higher dose and 0.4 percent of those on placebo. Researchers said no new safety signals emerged.
"That safety issue is important because upadacitinib is a systemic immune-modulating prescription drug," Kantor said. "Patients need appropriate medical evaluation and monitoring, and the potential benefits have to be weighed against the known risks."
He added that the results reflect a broader shift in alopecia care.
"For years, people with severe alopecia areata had relatively limited and often unpredictable options," Kantor said. "We are now getting therapies that target the underlying immune process.
"That gives patients and clinicians another reason to be optimistic, while still recognizing that no single treatment will be right for everyone."
Reference
Mostaghimi, A., et al. (2026). Upadacitinib for Severe Alopecia Areata in Adults and Adolescents: Two Phase 3 UP-AA Randomized Clinical Trials. JAMA Dermatology. 10.1001/jamadermatol.2026.2853.
Contact Newsweek editors on this story: Marc Vargas and Gray R. Thomas
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