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Published in: Dermatology and Therapy 4/2024

Open Access 21-03-2024 | Alopecia Areata | Brief Report

Characteristics and Management of Patients with Alopecia Areata and Selected Comorbid Conditions: Results from a Survey in Five European Countries

Authors: Sergio Vañó-Galván, Alexander Egeberg, Bianca Maria Piraccini, Simran Marwaha, Catherine Reed, Erin Johansson, Frederick Durand, Anthony Bewley

Published in: Dermatology and Therapy | Issue 4/2024

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Abstract

Introduction

Alopecia areata (AA) is an autoimmune condition that causes non-scarring hair loss and can impose a high psychosocial burden on patients. The presence of comorbid conditions may impact the management of AA in clinical practice. This analysis aims to describe disease characteristics and management of AA in patients with concomitant atopic, autoimmune, and psychiatric comorbid conditions.

Methods

Data were collected from the Adelphi Disease Specific Programme™, a cross-sectional survey of physicians and their adult patients with AA conducted in France, Germany, Italy, Spain, and the UK between October 2021 and June 2022. Patients’ disease severity was based on physician’s definition. Physician-reported data on demographics, AA clinical characteristics, comorbid conditions, and information related to AA therapies were analyzed. Analyses were descriptive.

Results

Overall, 239 dermatologists provided data for 2083 patients, of which 558 patients (27%) had at least one atopic, autoimmune, or psychiatric comorbid conditions. The most common comorbid conditions were atopic dermatitis, autoimmune thyroid disease, and anxiety. The mean (standard deviation) patient age for the three comorbidity groups was 37.6 years (12.1) and 56% of the patients were women (n = 313). In the three comorbidity groups, 51%, 50%, and 55% of patients with atopic, autoimmune, and psychiatric comorbidities had severe AA with disease progression reported as worsening in 30%, 28%, and 30%, respectively, whereas in the group with no comorbidities, 37% were described as having severe AA and 21% getting worse. Scalp hair loss was the primary sign reported across the three groups of comorbid conditions (atopic, 91%; autoimmune, 91%; psychiatric, 88%). Patients with preselected comorbidities presented more frequently AA-related signs and symptoms beyond scalp hair loss than patients without comorbid conditions. These patients were also more likely to receive topical calcineurin inhibitors, topical immunotherapy, conventional systemic immunosuppressants, and oral Janus kinase inhibitors for the treatment of their AA.

Conclusion

This analysis provided insights into the burden and management of AA in patients presenting with atopic, autoimmune, and psychiatric comorbid conditions in five European countries.
Literature
1.
go back to reference Lintzeri DA, Constantinou A, Hillmann K, Ghoreschi K, Vogt A, Blume-Peytavi U. Alopecia areata—current understanding and management. J Dtsch Dermatol Ges. 2022;20(1):59–90.PubMed Lintzeri DA, Constantinou A, Hillmann K, Ghoreschi K, Vogt A, Blume-Peytavi U. Alopecia areata—current understanding and management. J Dtsch Dermatol Ges. 2022;20(1):59–90.PubMed
2.
go back to reference Villasante Fricke AC, Miteva M. Epidemiology and burden of alopecia areata: a systematic review. Clin Cosmet Investig Dermatol. 2015;8:397–403.PubMedPubMedCentral Villasante Fricke AC, Miteva M. Epidemiology and burden of alopecia areata: a systematic review. Clin Cosmet Investig Dermatol. 2015;8:397–403.PubMedPubMedCentral
4.
go back to reference Messenger AG, McKillop J, Farrant P, McDonagh AJ, Sladden M. British Association of Dermatologists’ guidelines for the management of alopecia areata 2012. Br J Dermatol. 2012;166(5):916–26.CrossRefPubMed Messenger AG, McKillop J, Farrant P, McDonagh AJ, Sladden M. British Association of Dermatologists’ guidelines for the management of alopecia areata 2012. Br J Dermatol. 2012;166(5):916–26.CrossRefPubMed
5.
go back to reference Meah N, Wall D, York K, Bhoyrul B, Bokhari L, Sigall DA, et al. The alopecia areata consensus of experts (ACE) study: results of an international expert opinion on treatments for alopecia areata. J Am Acad Dermatol. 2020;83(1):123–30.CrossRefPubMed Meah N, Wall D, York K, Bhoyrul B, Bokhari L, Sigall DA, et al. The alopecia areata consensus of experts (ACE) study: results of an international expert opinion on treatments for alopecia areata. J Am Acad Dermatol. 2020;83(1):123–30.CrossRefPubMed
6.
go back to reference Rossi A, Muscianese M, Piraccini BM, Starace M, Carlesimo M, Mandel VD, et al. Italian guidelines in diagnosis and treatment of alopecia areata. G Ital Dermatol Venereol. 2019;154(6):609–23.CrossRefPubMed Rossi A, Muscianese M, Piraccini BM, Starace M, Carlesimo M, Mandel VD, et al. Italian guidelines in diagnosis and treatment of alopecia areata. G Ital Dermatol Venereol. 2019;154(6):609–23.CrossRefPubMed
7.
go back to reference Delamere FM, Sladden MM, Dobbins HM, Leonardi-Bee J. Interventions for alopecia areata. Cochrane Database Syst Rev. 2008;(2):CD004413. Delamere FM, Sladden MM, Dobbins HM, Leonardi-Bee J. Interventions for alopecia areata. Cochrane Database Syst Rev. 2008;(2):CD004413.
11.
go back to reference Lee S, Lee H, Lee CH, Lee WS. Comorbidities in alopecia areata: a systematic review and meta-analysis. J Am Acad Dermatol. 2019;80(2):466–77.e16.CrossRefPubMed Lee S, Lee H, Lee CH, Lee WS. Comorbidities in alopecia areata: a systematic review and meta-analysis. J Am Acad Dermatol. 2019;80(2):466–77.e16.CrossRefPubMed
12.
go back to reference Ly S, Manjaly P, Kamal K, et al. Comorbid conditions associated with alopecia areata: a systematic review and meta-analysis. Am J Clin Dermatol. 2023;24(6):875–93.CrossRefPubMed Ly S, Manjaly P, Kamal K, et al. Comorbid conditions associated with alopecia areata: a systematic review and meta-analysis. Am J Clin Dermatol. 2023;24(6):875–93.CrossRefPubMed
13.
go back to reference George P, Jagun O, Liu Q, et al. Prevalence of autoimmune and inflammatory diseases and mental health conditions among an alopecia areata cohort from a US administrative claims database. J Dermatol. 2023;50(9):1121–8.CrossRefPubMed George P, Jagun O, Liu Q, et al. Prevalence of autoimmune and inflammatory diseases and mental health conditions among an alopecia areata cohort from a US administrative claims database. J Dermatol. 2023;50(9):1121–8.CrossRefPubMed
14.
go back to reference Egeberg A, Anderson S, Edson-Heredia E, Burge R. Comorbidities of alopecia areata: a population-based cohort study. Clin Exp Dermatol. 2021;46(4):651–6.CrossRefPubMed Egeberg A, Anderson S, Edson-Heredia E, Burge R. Comorbidities of alopecia areata: a population-based cohort study. Clin Exp Dermatol. 2021;46(4):651–6.CrossRefPubMed
15.
go back to reference Holmes S, Harries M, Macbeth AE, Chiu WS, de Lusignan S, Messenger AG, Tziotzios C. Alopecia areata and risk of atopic and autoimmune conditions: population-based cohort study. Clin Exp Dermatol. 2023;48(4):325–31.CrossRefPubMed Holmes S, Harries M, Macbeth AE, Chiu WS, de Lusignan S, Messenger AG, Tziotzios C. Alopecia areata and risk of atopic and autoimmune conditions: population-based cohort study. Clin Exp Dermatol. 2023;48(4):325–31.CrossRefPubMed
16.
go back to reference Macbeth AE, Holmes S, Harries M, et al. The associated burden of mental health conditions in alopecia areata: a population-based study in UK primary care. Br J Dermatol. 2022;187(1):73–81.CrossRefPubMedPubMedCentral Macbeth AE, Holmes S, Harries M, et al. The associated burden of mental health conditions in alopecia areata: a population-based study in UK primary care. Br J Dermatol. 2022;187(1):73–81.CrossRefPubMedPubMedCentral
17.
go back to reference Senna M, Ko J, Tosti A, Edson-Heredia E, et al. Alopecia areata treatment patterns, healthcare resource utilization, and comorbidities in the US population using insurance claims. Adv Ther. 2021;38(9):4646–58.CrossRefPubMedPubMedCentral Senna M, Ko J, Tosti A, Edson-Heredia E, et al. Alopecia areata treatment patterns, healthcare resource utilization, and comorbidities in the US population using insurance claims. Adv Ther. 2021;38(9):4646–58.CrossRefPubMedPubMedCentral
18.
go back to reference Campos-Alberto E, Hirose T, Napatalung L, Ohyama M. Prevalence, comorbidities, and treatment patterns of Japanese patients with alopecia areata: a descriptive study using Japan medical data center claims database. J Dermatol. 2023;50(1):37–45.CrossRefPubMed Campos-Alberto E, Hirose T, Napatalung L, Ohyama M. Prevalence, comorbidities, and treatment patterns of Japanese patients with alopecia areata: a descriptive study using Japan medical data center claims database. J Dermatol. 2023;50(1):37–45.CrossRefPubMed
19.
go back to reference Anderson P, Benford M, Harris N, Karavali M, Piercy J. Real-world physician and patient behaviour across countries: disease-specific programmes—a means to understand. Curr Med Res Opin. 2008;24(11):3063–72.CrossRefPubMed Anderson P, Benford M, Harris N, Karavali M, Piercy J. Real-world physician and patient behaviour across countries: disease-specific programmes—a means to understand. Curr Med Res Opin. 2008;24(11):3063–72.CrossRefPubMed
21.
go back to reference World Medical Association Declaration of Helsinki. ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4.CrossRef World Medical Association Declaration of Helsinki. ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4.CrossRef
22.
go back to reference Huang KP, Mullangi S, Guo Y, Qureshi AA. Autoimmune, atopic, and mental health comorbid conditions associated with alopecia areata in the United States. JAMA Dermatol. 2013;149(7):789–94.CrossRefPubMed Huang KP, Mullangi S, Guo Y, Qureshi AA. Autoimmune, atopic, and mental health comorbid conditions associated with alopecia areata in the United States. JAMA Dermatol. 2013;149(7):789–94.CrossRefPubMed
24.
go back to reference Rabin RL, Levinson AI. The nexus between atopic disease and autoimmunity: a review of the epidemiological and mechanistic literature. Clin Exp Immunol. 2008;153(1):19–30.CrossRefPubMedPubMedCentral Rabin RL, Levinson AI. The nexus between atopic disease and autoimmunity: a review of the epidemiological and mechanistic literature. Clin Exp Immunol. 2008;153(1):19–30.CrossRefPubMedPubMedCentral
26.
go back to reference Trüeb RM, Dias M. Alopecia areata: a comprehensive review of pathogenesis and management. Clin Rev Allergy Immunol. 2018;54(1):68–87.CrossRefPubMed Trüeb RM, Dias M. Alopecia areata: a comprehensive review of pathogenesis and management. Clin Rev Allergy Immunol. 2018;54(1):68–87.CrossRefPubMed
27.
go back to reference Aldhouse NVJ, Kitchen H, Knight S, et al. “‘You lose your hair, what’s the big deal?’ I was so embarrassed, I was so self-conscious, I was so depressed:” a qualitative interview study to understand the psychosocial burden of alopecia areata. J Patient Rep Outcomes. 2020;4(1):76.CrossRefPubMedPubMedCentral Aldhouse NVJ, Kitchen H, Knight S, et al. “‘You lose your hair, what’s the big deal?’ I was so embarrassed, I was so self-conscious, I was so depressed:” a qualitative interview study to understand the psychosocial burden of alopecia areata. J Patient Rep Outcomes. 2020;4(1):76.CrossRefPubMedPubMedCentral
28.
go back to reference Mesinkovska N, King B, Mirmirani P, Ko J, Cassella J. Burden of illness in alopecia areata: a cross-sectional online survey study. J Investig Dermatol Symp Proc. 2020;20(1):S62–S68.CrossRefPubMed Mesinkovska N, King B, Mirmirani P, Ko J, Cassella J. Burden of illness in alopecia areata: a cross-sectional online survey study. J Investig Dermatol Symp Proc. 2020;20(1):S62–S68.CrossRefPubMed
29.
go back to reference Cranwell WC, Lai VW, Photiou L, et al. Treatment of alopecia areata: an Australian expert consensus statement. Aust J Dermatol. 2019;60(2):163–70.CrossRef Cranwell WC, Lai VW, Photiou L, et al. Treatment of alopecia areata: an Australian expert consensus statement. Aust J Dermatol. 2019;60(2):163–70.CrossRef
30.
go back to reference Phan K, Sebaratnam DF. JAK inhibitors for alopecia areata: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2019;33(5):850–6.CrossRefPubMed Phan K, Sebaratnam DF. JAK inhibitors for alopecia areata: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2019;33(5):850–6.CrossRefPubMed
Metadata
Title
Characteristics and Management of Patients with Alopecia Areata and Selected Comorbid Conditions: Results from a Survey in Five European Countries
Authors
Sergio Vañó-Galván
Alexander Egeberg
Bianca Maria Piraccini
Simran Marwaha
Catherine Reed
Erin Johansson
Frederick Durand
Anthony Bewley
Publication date
21-03-2024
Publisher
Springer Healthcare
Published in
Dermatology and Therapy / Issue 4/2024
Print ISSN: 2193-8210
Electronic ISSN: 2190-9172
DOI
https://doi.org/10.1007/s13555-024-01133-z

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