Patients Newly Diagnosed With Alopecia Areata at High Risk in Developing Psychiatric, Autoimmune Comorbidities

Individuals with alopecia areata (AA) have a higher chance of developing autoimmune or psychiatric comorbidities at the diagnosis of AA and demonstrated an elevated risk of new-onset autoimmune and psychiatric comorbidities compared with patients without alopecia areata, according to a recent study.

For their retrospective cohort analysis, Mostaghimi and colleagues collected patient data using the Merative MarketScan Research Databases, which contains medical and drug claims data from more than 46 million patients, from January 2007 to April 2023. The individuals included in the study were either diagnosed with AA (n = 63,384) or without (n = 3,309,107) and were aged between 12 to 64 years.

After matching the patients with AA to the controls (1:4), there were 16,512 patients in the AA group and 66,048 in the control group. Compared with the unmatched controls, patients diagnosed with AA had a higher prevalence of psychiatric (30.9% vs 26.8%; P < .001) and autoimmune (16.1% vs 8.9%; P < .0001) comorbidities at diagnosis. Further, the incidence of comorbidities was higher in patients with AA without a history of comorbidities compared with the matched control group.

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The study included some limitations. The researchers acknowledged that the data analyzed was from a large, diverse population of patients with AA. Secondly, the diagnosis of the comorbidity states was based on diagnostic codes, and the researchers did not have access to certain characteristics, such as laboratory values, that may have indicated an underlying comorbidity before the diagnosis of AA.

“This cohort study found that patients with AA have a higher incidence of several new-onset psychiatric and autoimmune comorbidities within the first year of diagnosis, which could further exacerbate the disease burden and reduce quality of life of those affected,” the researchers concluded. “Routine monitoring of patients with AA, especially those at risk of developing comorbidities, may permit earlier and more effective intervention.”

Reference:
Mostaghimi A, Soliman A, Li C, Barqawi YK, Grada A. Immune-mediated and psychiatric comorbidities among patients newly diagnosed with alopecia areata. JAMA Dermatol. Published online July 31, 2024. doi:10.1001/jamadermatol.2024.2404