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Treatment Patterns for Alopecia Areata in the US
Hemin Lee1,2, Kathie P Huang3,4, Arash Mostaghimi3,4
1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
JAMA Dermatology
|September 20, 2023
Summary
Corticosteroids were the most frequent alopecia areata (AA) treatment from 2015-2020. However, over two-thirds of patients with AA received no treatment 365 days post-diagnosis, highlighting a gap in care.
Area of Science:
- Dermatology
- Pharmacology
- Health Services Research
Background:
- Alopecia areata (AA) presents varied hair loss, with no consensus on optimal treatment strategies.
- Understanding current treatment patterns is crucial for identifying needs and developing standards of care for AA, including alopecia totalis (AT) and alopecia universalis (AU).
Purpose of the Study:
- To analyze treatment patterns for adult patients diagnosed with alopecia areata (AA) in the United States between 2015 and 2020.
Main Methods:
- A retrospective cohort study utilized IBM MarketScan Research Database claims for commercially insured adults (≥18 years) newly treated for AA (ICD-10 code L63.x).
- The study assessed treatment patterns during the first year post-diagnosis, including subgroups with AT/AU and those seen by a dermatologist.
- Statistical analyses were performed between 2019 and 2023 on a cohort of 45,483 individuals with continuous enrollment.
Main Results:
- Corticosteroids were the most common treatments: intralesional (41.8%), topical (40.9%), intramuscular (38.1%), and oral (20.6%).
- Patients with AT/AU showed different steroid usage patterns compared to those without extensive disease.
- A significant proportion of patients (47.2%) received no treatment on diagnosis day, and 71.8% were untreated by 12 months.
Conclusions:
- Corticosteroids were the predominant treatment for alopecia areata (AA) in US adults from 2015-2020.
- A majority of patients with AA were not receiving treatment within a year of diagnosis, indicating potential unmet needs.
- Further research is warranted to explore the reasons behind the high rate of untreated alopecia areata.
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