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JAADObservational study

Long-term efficacy and safety of upadacitinib in the treatment of alopecia areata: A retrospective study.

Wang H, Li X, Sun Y, Li J, Zhang J, Zhou C

Journal of the American Academy of DermatologyIn the feed 31 Jul 2026, published online 31 Jul 2026, issue 2026 Jul 31, added to PubMed 31 Jul 2026

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Abstract

BACKGROUNDLong-term efficacy and safety of upadacitinib for alopecia areata is unknown in real-world practice.

OBJECTIVETo evaluate long-term efficacy and safety of upadacitinib in a real-world setting and to explore the predictive factors that may influence the treatment response.

METHODSA retrospective study was conducted on 30 patients continuously taking upadacitinib for at least 12 months. The disease severity was evaluated at baseline and every 3 months. Adverse events occurred during treatment were systematically recorded.

RESULTSA total of 30 patients were included (73.33% female; 36.67% with atopic background; 7 children, 6 adolescents and 17 adult). The primary end points were the Severity of Alopecia Tool50, Severity of Alopecia Tool75, and Severity of Alopecia Tool90 response rates at months 12, which were 90.0%, 80.0%, and 56.67%, respectively, and showed an upward trend over time. The Severity of Alopecia Tool score improvement of patients with atopic background was better than those without atopic background in the early stage of treatment. No serious adverse events were reported throughout the study period.

LIMITATIONSSingle-center, retrospective study and relatively small sample size.

CONCLUSIONLong-term treatment of alopecia areata with upadacitinib has significant efficacy and favorable safety in real-world setting. Patients with atopic background are more likely to achieve the efficacy target in the early stage.

Abstract from PubMed

PMID 42537850 · DOI 10.1016/j.jaad.2026.07.098

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