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. 2024 Apr;14(4):1027-1037.
doi: 10.1007/s13555-024-01133-z. Epub 2024 Mar 21.

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

Sergio Vañó-Galván  1 , Alexander Egeberg  2   3 , Bianca Maria Piraccini  4 , Simran Marwaha  5 , Catherine Reed  6 , Erin Johansson  6 , Frederick Durand  6 , Anthony Bewley  7
Affiliations

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

Sergio Vañó-Galván et al. Dermatol Ther (Heidelb). 2024 Apr.

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.

Keywords: Alopecia areata; Comorbid conditions; Disease management.

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Conflict of interest statement

Sergio Vañó-Galván reports consulting fees and payment/honoraria from Pfizer and Lilly. Alexander Egeberg reports grants from Abbvie, Danish Nathional Psoriasis Foundation, Eli Lilly, Janssen, Kgl. Hofbundtmager Aage Bangs Foundation, Novartis, Pfizer, Boehringer Ingelheim, Bristol-Myers Squibb, Almirall and Simon Spies Foundation in relation to research funding. Consulting fees from AbbVie, Almirall, Boehringer Ingelheim, Bristol-Myers Squibb, Dermavant, Eli Lilly, Galderma, Galapagos NV, Janssen, LEO Pharma, Mylan, Novartis, Pfizer, Samsung Bioepis Co., Ltd., UCB, Union Therapeutics and Horizon Therapeutics. Payment/honoraria from AbbVie, Almirall, Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Boehringer Ingelheim, Bristol-Myers Squibb, Dermavant, Eli Lilly, Galderma, Janssen, LEO Pharma, Mylan, Novartis, Pfizer, Samsung Bioepis Co., Ltd. and UCB. Support for attending congresses from Abbvie, Eli Lilly, Bristol-Myers Squibb and Janssen. Participation on a Data Safety Monitoring Board or Advisory Board from Samsung Bioepis and Horizon Therapeutics. Bianca Maria Piraccini received payment/honoraria from Pierre fabre-Ducray, ISDIN, Legacy Healthcare, Pfizer, Almirall, Eli Lilly, Difa Cooper and Dercos-L’Oreal. Simran Marwaha is an employee of Adelphi Real World. Anthony Bewley reports royalties from Wiley. Ad hoc consultancy with Abbvie, Almirall, Lilly, UCB, Pfizer, Sanofi, Leo Pharma, Galderma, Janssen, Novartis and BMS. Travel support to attend congresses from Almirall, Lilly, Janssen. Catherine Reed, Erin Johansson and Frederick Durandare employees and minor shareholders of Eli Lilly and Company.

Figures

Fig. 1
Fig. 1
Current signs and symptoms related to AA in patients with and without preselected comorbidities. AA alopecia areata
Fig. 2
Fig. 2
Current treatments for AA in patients with and without preselected comorbidities. AA alopecia areata, CI calcineurin inhibitors, CS corticosteroid, CSI conventional systemic immunosuppressant, IMT immunotherapy, JAK Janus kinase, JAKi Janus kinase inhibitor. Systemic CS included oral and intravenous CS. Conventional systemic immunosuppressants included azathioprine, cyclosporine, or methotrexate. Topical CI included topical pimecrolimus and tacrolimus. Topical immunotherapy included diphencyprone, squaric acid dibutylester, dinitrochlorobenzene, and others. Oral JAKi included baricitinib, ruxolitinib, tofacitinib, and other JAKis. Physicians could list more than one treatment
See this image and copyright information in PMC

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