Disease burden, clinical management and unmet treatment need of patients with moderate to severe alopecia areata; consensus statements, insights, and practices from CERTAAE (Central/Eastern EU, Russia, Türkiye AA experts) Delphi panel

Lidia Rudnicka¹, Magdalena Trzeciak², Erkan Alpsoy³, Petr Arenberger⁴, Sibel Alper⁵, Nina Benáková⁶, Svetlana Bobko⁷, Murat Borlu⁸, Magdalena Czarnecka Operacz⁹, Burhan Engin¹⁰, Tülin Ergun¹¹, Ilgen Ertam Sağduyu¹², Olga Filipovská¹³, Aida Gadzhigoroeva¹⁴, Martina Kojanová⁶, Aleksandra Lesiak¹⁵, Anna Michenko^{7

16

17}, Nikolay Murashkin^{18

19

20

21}, Nahide Onsun²², Witold Owczarek²³, Zuzana Plzakova⁶, Adam Reich²⁴, Marie Selerová²⁵, Burcu Aybike Gürbüz²⁶

Affiliations

¹ Department of Dermatology, Medical University of Warsaw, Warsaw, Poland.
² Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland.
³ Department of Dermatology and Venereology, Akdeniz University School of Medicine, Antalya, Türkiye.
⁴ Department of Dermatovenerology, Third Faculty of Medicine, Charles University, Prague, Czechia.
⁵ Department of Dermatology and Venereology, Koç University, İstanbul, Türkiye.
⁶ Department of Dermatovenereology, First Faculty of Medicine, Charles University, Prague, Czechia.
⁷ Moscow Scientific and Practical Centre of Dermatovenereology and Cosmetology, Moscow, Russia.
⁸ Dermatology and Venereology Department, Erciyes University, Kayseri, Türkiye.
⁹ Department of Dermatology, Medical University of Poznań, Poznań, Poland.
¹⁰ Department of Dermatology and Venerology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, İstanbul, Türkiye.
¹¹ Department of Dermatology, Marmara University, İstanbul, Türkiye.
¹² Department of Dermatology, Ege University, Izmir, Türkiye.
¹³ Department of Dermatology, Masaryk Hospital in Ústí nad Labem, Ústí nad Labem, Czechia.
¹⁴ Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia.
¹⁵ Laboratory of Autoinflammatory, Genetic and Rare Skin Disorders, Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, Lodz, Poland.
¹⁶ Federal State Budgetary Institution of Continuing Professional Education, Central State Medical Academy, Moscow, Russia.
¹⁷ Medical Research and Educational Center, Lomonosov Moscow State University, Moscow, Russia.
¹⁸ National Medical Research Center for Children's Health, Moscow, Russia.
¹⁹ Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
²⁰ Dermatology Department, Federal State Autonomous Institution, Scientific Centre of Children's Health of the Ministry of Health of the Russian Federation, Moscow, Russia.
²¹ Research Institute for Pediatrics and Children's Health Protection, Federal National Public Healthcare Institution "Central Clinical Hospital of the Russian Academy of Sciences", Ministry of Science and Higher Education, Moscow, Russia.
²² Dermatology Department, Bezmialem Vakıf University, İstanbul, Türkiye.
²³ Department of Dermatology, Military Institute of Medicine, Warsaw, Poland.
²⁴ Department of Dermatology, University of Rzeszów, Rzeszów, Poland.
²⁵ Department of Dermatology, Hospital AGEL Novy Jicin, JSC, Novy Jicin, Czechia.
²⁶ Medical Affairs, Pfizer, İstanbul, Türkiye.

PMID: 38741770
PMCID: PMC11089289
DOI: 10.3389/fmed.2024.1353354

Disease burden, clinical management and unmet treatment need of patients with moderate to severe alopecia areata; consensus statements, insights, and practices from CERTAAE (Central/Eastern EU, Russia, Türkiye AA experts) Delphi panel

Lidia Rudnicka et al. Front Med (Lausanne). 2024.

. 2024 Apr 22:11:1353354.

doi: 10.3389/fmed.2024.1353354. eCollection 2024.

Authors

Affiliations

¹ Department of Dermatology, Medical University of Warsaw, Warsaw, Poland.
² Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland.
³ Department of Dermatology and Venereology, Akdeniz University School of Medicine, Antalya, Türkiye.
⁴ Department of Dermatovenerology, Third Faculty of Medicine, Charles University, Prague, Czechia.
⁵ Department of Dermatology and Venereology, Koç University, İstanbul, Türkiye.
⁶ Department of Dermatovenereology, First Faculty of Medicine, Charles University, Prague, Czechia.
⁷ Moscow Scientific and Practical Centre of Dermatovenereology and Cosmetology, Moscow, Russia.
⁸ Dermatology and Venereology Department, Erciyes University, Kayseri, Türkiye.
⁹ Department of Dermatology, Medical University of Poznań, Poznań, Poland.
¹⁰ Department of Dermatology and Venerology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, İstanbul, Türkiye.
¹¹ Department of Dermatology, Marmara University, İstanbul, Türkiye.
¹² Department of Dermatology, Ege University, Izmir, Türkiye.
¹³ Department of Dermatology, Masaryk Hospital in Ústí nad Labem, Ústí nad Labem, Czechia.
¹⁴ Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia.
¹⁵ Laboratory of Autoinflammatory, Genetic and Rare Skin Disorders, Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, Lodz, Poland.
¹⁶ Federal State Budgetary Institution of Continuing Professional Education, Central State Medical Academy, Moscow, Russia.
¹⁷ Medical Research and Educational Center, Lomonosov Moscow State University, Moscow, Russia.
¹⁸ National Medical Research Center for Children's Health, Moscow, Russia.
¹⁹ Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
²⁰ Dermatology Department, Federal State Autonomous Institution, Scientific Centre of Children's Health of the Ministry of Health of the Russian Federation, Moscow, Russia.
²¹ Research Institute for Pediatrics and Children's Health Protection, Federal National Public Healthcare Institution "Central Clinical Hospital of the Russian Academy of Sciences", Ministry of Science and Higher Education, Moscow, Russia.
²² Dermatology Department, Bezmialem Vakıf University, İstanbul, Türkiye.
²³ Department of Dermatology, Military Institute of Medicine, Warsaw, Poland.
²⁴ Department of Dermatology, University of Rzeszów, Rzeszów, Poland.
²⁵ Department of Dermatology, Hospital AGEL Novy Jicin, JSC, Novy Jicin, Czechia.
²⁶ Medical Affairs, Pfizer, İstanbul, Türkiye.

PMID: 38741770
PMCID: PMC11089289
DOI: 10.3389/fmed.2024.1353354

Abstract

Objectives: This study aims to update the understanding of Alopecia Areata (AA) in Poland, Czechia, Russia, and Türkiye, focusing on the disease burden, clinical management, and patient journey. It seeks to establish a consensus on optimal management strategies for AA in these regions.

Methods: A modified 2-round Delphi panel was conveyed with 23 Dermatologists (Russia; 4, Türkiye; 7, Poland; 6, and Czechia; 6). The Delphi questionnaire consisted of 61 statements and 43 questions designed to obtain an overall understanding of the perception and acceptance of available information regarding the care of patients with alopecia areata.

Results: The study revealed that moderate-to-severe AA significantly impacts patients' and their families' QoL, consistent with previous studies. AA was found to cause more substantial impairment when additional lesions appeared in visible areas besides the scalp. Work and productivity impairment were notably higher in adults with moderate-to-severe AA. Diagnostic consensus highlighted the importance of skin biopsies and trichoscopy, while the need for more practical severity scoring systems was emphasized. Current treatments, including topical therapies, corticosteroids, and systemic immune modifiers, were deemed insufficient, highlighting the unmet medical need.

Conclusion: The Delphi study underscores a significant disease burden and unmet medical needs in patients with moderate-to-severe AA. It highlights the necessity of access to novel treatments and further research to develop more effective therapies with a tolerable safety profile. The findings align with global research, emphasizing the psychosocial impact of AA and the need for standardized, effective treatment protocols.

Keywords: alopecia areata; clinical management; diagnosis; disease burden; treatment.

Copyright © 2024 Rudnicka, Trzeciak, Alpsoy, Arenberger, Alper, Benáková, Bobko, Borlu, Czarnecka Operacz, Engin, Ergun, Sağduyu, Filipovská, Gadzhigoroeva, Kojanová, Lesiak, Michenko, Murashkin, Onsun, Owczarek, Plzakova, Reich, Selerová and Gürbüz.

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Conflict of interest statement

PA has acted in advisory board of AbbVie, Bristol Myers Squibb, Merck Sharp Dohme, Novartis, Pfizer Pharmaceuticals, and has received speaker honorarium from Pfizer, Abbvie. MK has served as consultant, speaker, or investigator for Abbvie, Almirall, Amgen, Eli Lilly, Janssen, Leo Pharma, Novartis, Pfizer, Sanofi and UCB. MC has acted on the advisory board of Novartis, Pfizer Pharmaceuticals, and Bristol Myers Squibb and has received a speaker honorarium from Pfizer, Abbvie, OF has acted in advisory board of Novartis, Lilly, LeoPharma, Almirall and in clinical studies Pfizer, Janssen, Lilly, Amgen, Abbvie, Novartis, Regeneron. AM has acted in advisory board of Novartis, Pfizer Pharmaceuticals, and Bristol Myers Squibb and has received speaker honorarium from L’Oreal, La Roche Posay. MT has been a speaker and/or consultant an/or investigator and/or participant of Advisory Board of Abbvie, BauschHealth, Bioderma, Eli Lilly, La Roche, Leo pharma, Novartis, Pfizer, Pierre-Fabre, Sanofi Genzyme. ZP has acted in advisory board of Novartis, Pfizer Pharmaceuticals, and Bristol Myers Squibb and has received speaker honorarium from Pfizer, Abbvie. IS has acted in advisory board of Novartis, Pfizer Pharmaceuticals, and Bristol Myers Squibb and has received speaker honorarium from Pfizer, Abbvie. WO received honorarium for lectures and clinical research from AbbVie, Aflofarm Farmacja, Alfasigma, Almirall, Amgen, Apotex Polska Astellas Pharma, AstraZeneca, Bausch Health Poland, Berlin Chemie Menarini, Boehringer Ingelheim, Bristol Myers Squibb, EGIS, Eli Lilly, Galderma, Janssen-Cilag, LEO Pharma, Medac GmbH, Merck, Mylan Healthcare, Novartis, Pfizer, Pierre Fabre Medicamente, TZF Polfa S.A., Roche Diagnostics, Sandoz, Sanofi-Aventis, SUN-FARM, Teva Pharmaceuticals, UCB Pharma. AL has acted in advisory board of Novartis, Pfizer Pharmaceuticals, Abbvie, Sanofie, Sandoz, Lilly, Janssen, Almiral and has received speaker honorarium from Pfizer, Abbvie, Novartis, Pfizer Pharmaceuticals, Abbvie, Sanofie, Sandoz, Lilly, Almiral, UCB. AG has received speaker honorarium from Pfizer. NM reports grants and personal fees from Jansen, grants from Eli Lilly, grants and personal fees from Novartis, personal fees from Galderma, personal fees from Pierre Fabre, personal fees from Bayer, personal fees from Leofarma, grants and personal fees from Pfizer, grants and personal fees from AbbVie, grants from Amryt Pharma, personal fees and non-financial support from Viatris, outside the submitted work. NB declare to have acted as member of Advisory Board of Pfizer Pharmaceuticals and has received speaker honorarium from Pfizer. SB has received speaker honorarium from Pfizer, LEO PHARMAEB has acted in advisory board of Novartis and Pfizer Pharmaceuticals has received speaker honorarium from Pfizer, Abbvie. SA has acted in advisory board of Novartis, Pfizer and Bristol Myers Squibb, and has received honorarium from Pfizer and Abbvie. AR has worked as a consultant or speaker for AbbVie, Bioderma, Celgene, Chema Elektromet, Eli Lilly, Galderma, Janssen, Leo Pharma, Medac, Menlo Therapeutics, Novartis, Pierre-Fabre, Sandoz and Trevi and has participated as principal investigator in clinical trials sponsored by AbbVie, Almirall, Amgen, Anaptys, Argenx, Biogen, Biothera, BMS, Celltrion, Dermira, Dice, Evelo, Galderma, Genentech, Horizon Therapeutics, Incyte, Janssen, Kymab Ltd., Leo Pharma, Eli Lilly, Menlo Therapeutics, MetrioPharm, MSD, Novartis, Pfizer, Regeneron, Sanofi, Takeda, Trevi, and UCB. BG is an employee of Pfizer. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Disease burden, clinical management and unmet treatment need of patients with moderate to severe alopecia areata; consensus statements, insights, and practices from CERTAAE (Central/Eastern EU, Russia, Türkiye AA experts) Delphi panel

Affiliations

Disease burden, clinical management and unmet treatment need of patients with moderate to severe alopecia areata; consensus statements, insights, and practices from CERTAAE (Central/Eastern EU, Russia, Türkiye AA experts) Delphi panel

Authors

Affiliations

Abstract

Conflict of interest statement

References

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