Most Patients With Alopecia Areata No Longer Receive Treatment 1-Year After Diagnosis

In a retrospective cohort study of more than 45,000 adults in the United States with alopecia areata (AA), researchers found that about half of patients did not receive treatment on the day of diagnosis and almost three-quarters of patients were not receiving treatment at 1-year after diagnosis.

For their study, Lee and colleagues examined medical and pharmacy claims data from a large health care database to assess US adults treated for AA between October 15, 2015, and February 28, 2020. The study population included a total of 45,483 individuals (65.7% female), with a mean age of 43.8 years.

Lee and colleagues looked at treatment patterns for all patients with AA and certain subgroups including alopecia totalis and alopecia universalis. They also measured whether those in the study cohort were treated by a dermatologist on the cohort entry date, as well the cohort’s longitudinal therapy course at 1-year after diagnosis.

The results of the study showed that during the year of diagnosis, 30,217 patients (66.4%) received at least one AA treatment by a dermatologist. The most common treatments were intralesional (41.8%), topical (40.9%), intramuscular (38.1%), and oral corticosteroids (20.6%).

Patients diagnosed with either alopecia totalis or alopecia universalis were less likely to receive intralesional steroids and more likely to receive topical corticosteroids than those without these diagnoses, the authors noted.

The study results also showed that almost half of patients (47.2%) received no treatment on the day of diagnosis, and at 1-year after diagnosis, 71.8% of patients were no longer receiving any treatment for AA. The researchers indicated that future studies are needed to better understand why treatment tends to end 1-year after a diagnosis.

“In this large cohort study of commercially insured individuals, corticosteroids were the most commonly used treatment for adults with AA between 2015 and 2020,” the authors concluded. “At 365 days after diagnosis, more than two-thirds of patients were no longer receiving any AA treatment. Further studies are needed to understand the reasons for the absence of treatment.”

Reference

Lee H, Huang KP, Mostaghimi A, Choudhry NK. Treatment patterns for alopecia areata in the US. JAMA Dermatol. Published September 20, 2023: doi: 10.1001/jamadermatol.2023.3109.