Deuruxolitinib Hair Regrowth Responses Similar With or Without Nail Involvement in Severe Alopecia Areata
Key Takeaways
- In a pooled post hoc analysis of THRIVE-AA1 and THRIVE-AA2, week 24 scalp hair regrowth responses to deuruxolitinib 8 mg twice daily were similar in adults with severe alopecia areata regardless of baseline nail involvement.
- A Severity of Alopecia Tool (SALT) score of 20 or lower was achieved by 29.5% of patients with nail involvement and 31.5% without it; SALT scores of 10 or lower occurred in 20.7% and 23.0%, respectively.
- Responses in both nail-involvement subgroups were significantly higher with deuruxolitinib than with placebo. Nail involvement was assessed using a binary yes/no rating, and the post hoc design limits interpretation.
Baseline nail involvement was not associated with a statistically significant difference in scalp hair regrowth among adults with severe alopecia areata receiving deuruxolitinib 8 mg twice daily, according to a pooled post hoc analysis of the phase 3 THRIVE-AA1 and THRIVE-AA2 trials presented at the 2026 Fall Clinical Dermatology Conference.
Natasha Atanaskova Mesinkovska, MD, PhD, and colleagues examined 24-week outcomes in adults aged 18 to 65 years with at least 50% scalp hair loss and an alopecia areata episode lasting 6 months to 10 years. The pooled comparison included 600 patients receiving the oral JAK1/JAK2 inhibitor and 267 receiving placebo. Baseline nail involvement was identified through a yes-or-no investigator assessment.
At baseline, nail involvement was reported in 38.8% of the deuruxolitinib group and 38.6% of the placebo group.
Week 24 Hair Regrowth Outcomes
Among patients with nail involvement, 29.5% (64/217) receiving deuruxolitinib achieved a Severity of Alopecia Tool (SALT) score of 20 or lower at week 24, compared with none of 95 placebo recipients (P < .0001). Among those without nail involvement, the corresponding rates were 31.5% (104/330) and 1.3% (2/151; P < .0001).
More stringent SALT scores of 10 or lower occurred in 20.7% of deuruxolitinib recipients with nail involvement and 23.0% without it; neither placebo subgroup had responders (both P < .0001). Response rates did not differ significantly between treated patients with and without nail involvement for SALT 20 or lower (P = .9224) or SALT 10 or lower (P = .9004).
“The proportions of patients who achieved SALT scores ≤20 and ≤10 at Week 24 with deuruxolitinib were similar among those with and without nail involvement, and were significantly greater than placebo, suggesting that baseline nail involvement does not impact the efficacy of deuruxolitinib,” the authors concluded.