In this interview, Melinda Gooderham, MD, MSc, touches on eyebrow and eyelash regrowth data and safety findings for upadacitinib in severe alopecia areata.
Melinda Gooderham, MD, MSc, medical director of the SKiN Centre for Dermatology in Peterborough, Ontario, continued her discussion of
Both replicate global trials randomized adolescent and adult patients with severe alopecia areata, defined as a Severity of Alopecia Tool (SALT) score of 50 or greater, to 15 mg upadacitinib, 30 mg upadacitinib, or placebo, with a primary end point of SALT score 20 or less at the 24-week mark.
Gooderham said eyebrow and eyelash outcomes were clinically meaningful secondary end points, noting that roughly two-thirds of patients had significant eyebrow loss and half had significant eyelash loss at baseline. She explained that this type of hair loss is particularly difficult for patients to conceal compared with scalp hair loss, and also carries functional consequences, since eyebrows and eyelashes help protect the eyes from sweat and debris. At Week 24, approximately 40% of patients on the 15-mg dose and 60% of patients on the 30-mg dose achieved meaningful eyebrow and eyelash regrowth.
Gooderham said no new safety signals were identified in the trials, reinforcing her confidence in upadacitinib given the extensive existing safety data from other approved indications, including atopic dermatitis, rheumatoid arthritis, and inflammatory bowel disease. She noted that in a cross-trial comparison, other therapies for severe alopecia areata have shown SALT score 20 or less response rates around 35%, compared with 45% and 55% for the 15-mg and 30-mg upadacitinib doses, respectively, though she cautioned this was not a head-to-head comparison.
Gooderham said the data may raise the standard of care for patients with severe alopecia areata, many of whom have previously abandoned treatment. She emphasized that upadacitinib's benefits extend beyond the scalp to eyebrows, eyelashes, and beard growth in men, and pointed to a favorable risk-benefit profile in adolescents specifically, a population in which alopecia areata can carry significant psychosocial impact.
Editor’s note: Gooderham’s has previously reported non-financial support from Takeda in addition to personal fees from AbbVie, Amgen, Arcutis, Bristol Myers Squibb, Boehringer Ingelheim, Eli Lilly, Galderma, Incyte, Janssen, Leo Pharma, Meiji, Dermavant, Moonlake, Nektar, Nimbus, Novartis, Pfizer, Regeneron, Sanofi, Sun Pharma, Tarsus, Takeda, UCB, Union, Ventyx, and Apogee.
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