Overview Of Alopecia Areata For Managed Care And Payer Stakeholders In The United States

May 2023 in “ Journal of managed care & specialty pharmacy ”

Brett King, Edmund J. Pezalla, Selwyn Fung, Helen Tran, J Bourret, Kathleen Peeples-Lamirande, Liza Takiya, Lynne Napatalung

alopecia areata autoimmune disease hair loss corticosteroids systemic immunosuppressants topical immunotherapy Janus kinase inhibitors JAK inhibitors baricitinib deuruxolitinib ritlecitinib FDA AA

From the encyclopedia

Alopecia Areata →

autoimmune disorder causing patchy hair loss

Baricitinib →

JAK inhibitor that reduces inflammation and immune attacks on hair follicles, leading to potential hair regrowth, especially in alopecia areata cases

Studysummary This review discusses the pathophysiology, economic burden, and treatment options of alopecia areata and reports no new clinical results, highlighting the need for better therapies, including JAK inhibitors. Our plain-language summary of this paper — not a Tressless recommendation.

Alopecia areata (AA) is an autoimmune disease causing hair loss in genetically susceptible individuals, significantly impacting their quality of life and posing an economic burden due to costs associated with treatments and cosmetic options. Current treatments include corticosteroids, systemic immunosuppressants, and topical immunotherapy, but these have limited effectiveness, with 78% of over 1,000 surveyed patients expressing dissatisfaction. However, new therapies like Janus kinase (JAK) inhibitors, including baricitinib, deuruxolitinib, and ritlecitinib, are showing promise. Baricitinib has been approved by the FDA, with 39% and 23% of patients showing a response to 4 mg and 2 mg doses respectively. Despite these advancements, high relapse rates when treatment is discontinued indicate the need for ongoing therapy. AA is also associated with various comorbidities, including mental health conditions, and significantly impairs health-related quality of life.

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Research cited in this study

32 / 32 results

research Efficacy and Safety of Ritlecitinib in Adults and Adolescents With Alopecia Areata: A Randomised, Double-Blind, Multicentre, Phase 2b–3 Trial

227 citations , April 2023 in “The Lancet”

Ritlecitinib effectively treats alopecia areata and is well-tolerated.

Chronic Myeloid Leukemia: Part I—Real-World Treatment Patterns, Healthcare Resource Utilization, and Associated Costs in Later Lines of Therapy in the United States

research Chronic Myeloid Leukemia: Part I—Real-World Treatment Patterns, Healthcare Resource Utilization, and Associated Costs in Later Lines of Therapy in the United States

6 citations , July 2022 in “Journal of health economics and outcomes research”

This study found that US adolescents with alopecia areata, especially those with alopecia totalis or universalis, experience significantly higher healthcare costs and resource use compared to matched controls.

research Healthcare Utilization And Costs Among US Adolescents With Alopecia Areata

4 citations , July 2022 in “Journal of health economics and outcomes research”

This review discusses the economic burden of alopecia areata in adolescents and reports no new results; the authors note that evidence in this area is limited.

research Economic Burden and Healthcare Resource Use of Alopecia Areata in an Insured Population in the USA

12 citations , April 2022 in “Dermatology and therapy”

This study reports that patients with alopecia areata in the US incur significantly higher healthcare utilization and expenses, primarily driven by ambulatory and pharmacy costs, compared to matched controls.

research Two Phase 3 Trials of Baricitinib for Alopecia Areata

148 citations , March 2022 in “The New England Journal of Medicine”

In two phase 3 trials, this study found that oral baricitinib significantly improved hair regrowth compared to placebo in adults with severe alopecia areata after 36 weeks, though longer trials are needed to ascertain its long-term efficacy and safety.

research Prevalence and Risk Factors Associated with the Occurrence of Autoimmune Diseases in Patients with Alopecia Areata

14 citations , September 2021 in “Journal of Inflammation Research”

This study suggests that female patients with alopecia areata, especially those with nail abnormalities and atopic diseases, may have higher rates of coexisting autoimmune diseases.

Alopecia Areata Treatment Patterns, Healthcare Resource Utilization, and Comorbidities in the US Population Using Insurance Claims

research Alopecia Areata Treatment Patterns, Healthcare Resource Utilization, and Comorbidities in the US Population Using Insurance Claims

23 citations , July 2021 in “Advances in Therapy”

This study observed that patients with alopecia areata often have comorbidities and experience significant healthcare costs, with treatments like systemic therapies being infrequently used.

research Treatment of Pediatric Alopecia Areata: A Systematic Review

48 citations , April 2021 in “Journal of the American Academy of Dermatology”

This study found that topical corticosteroids are the most supported first-line treatment for pediatric alopecia areata, with contact immunotherapy as the next best option.

research Patient Perspectives of the Social, Emotional and Functional Impact of Alopecia Areata: A Systematic Literature Review

67 citations , March 2021 in “Dermatology and Therapy”

This review discusses the substantial impact of alopecia areata on patients' health-related quality of life, highlighting issues such as personality changes, emotional and social difficulties, and a common occurrence of alexithymia, and emphasizes the need for more specific assessment tools.

research Androgenetic Alopecia in Women and Men: Italian Guidelines Adapted from European Dermatology Forum/European Academy of Dermatology and Venereology Guidelines

4 citations , December 2020 in “Giornale italiano di dermatologia e venereologia”

This guideline summarizes evidence-based and expert-based recommendations for treating androgenetic alopecia, adapted by an Italian expert group in alignment with Italian pharmacological policies.

‘You Lose Your Hair, What’s the Big Deal?’ I Was So Embarrassed, I Was So Self-Conscious, I Was So Depressed: A Qualitative Interview Study to Understand the Psychosocial Burden of Alopecia Areata

research ‘You Lose Your Hair, What’s the Big Deal?’ I Was So Embarrassed, I Was So Self-Conscious, I Was So Depressed: A Qualitative Interview Study to Understand the Psychosocial Burden of Alopecia Areata

30 citations , September 2020 in “Journal of Patient-Reported Outcomes”

This study found that alopecia areata significantly impacts emotional and psychological well-being, relationships, and lifestyles, highlighting the need for increased awareness and effective treatments.

Utility of Azathioprine, Methotrexate, and Cyclosporine as Steroid-Sparing Agents in Chronic Alopecia Areata: A Retrospective Study of Continuation Rates in 138 Patients

research Utility of Azathioprine, Methotrexate, and Cyclosporine as Steroid-Sparing Agents in Chronic Alopecia Areata: A Retrospective Study of Continuation Rates in 138 Patients

12 citations , August 2020 in “JEADV. Journal of the European Academy of Dermatology and Venereology/Journal of the European Academy of Dermatology and Venereology”

This study found that most chronic alopecia areata patients treated with azathioprine, methotrexate, or cyclosporine continued treatment for at least 12 months, often requiring concurrent low-dose prednisolone.

research A Large Cross-Sectional Survey Study of the Prevalence of Alopecia Areata in the United States

63 citations , March 2020 in “Clinical Cosmetic and Investigational Dermatology”

This study suggests that the prevalence of alopecia areata in the US remains similar to high estimates from the 1970s, with significant implications for quality of life.

research The Alopecia Areata Investigator Global Assessment Scale: A Measure for Evaluating Clinically Meaningful Success in Clinical Trials

86 citations , January 2020 in “British Journal of Dermatology”

This study developed the Alopecia Areata Investigator Global Assessment (AA-IGA) to measure scalp-hair loss in alopecia areata patients, incorporating perspectives of both patients and clinicians to define treatment success.

research Assessment of a Bidirectional Association Between Major Depressive Disorder and Alopecia Areata

37 citations , January 2019 in “JAMA Dermatology”

This study found a bidirectional relationship between major depressive disorder and alopecia areata, with each condition significantly increasing the risk of subsequently developing the other.

research Alopecia Areata: A Multifactorial Autoimmune Condition

148 citations , December 2018 in “Journal of autoimmunity”

This review discusses genetic and environmental factors contributing to autoimmunity in alopecia areata and reports no new clinical findings, emphasizing the need for further study on its aetiology and pathophysiology.

research Treatment of Alopecia Areata: An Australian Expert Consensus Statement

95 citations , November 2018 in “Australasian journal of dermatology”

This consensus statement outlines a treatment algorithm for alopecia areata, discussing when to consider systemic treatment and how to assess outcomes, without providing new clinical results.

research Rethinking The Classification Of Alopecia Areata

13 citations , September 2018 in “Journal of the American Academy of Dermatology”

This editorial proposes a new classification for alopecia areata that incorporates the SALT score and body hair involvement, aiming to improve the assessment and treatment outcomes.

research Systemic Treatments for Alopecia Areata: A Systematic Review

41 citations , September 2018 in “Australasian journal of dermatology”

This review suggests that oral prednisolone pulse therapy and oral inosiplex may be effective for alopecia areata, but robust evidence from randomized controlled trials is lacking, highlighting the need for better-designed future studies.

research Comorbidities in Alopecia Areata: A Systematic Review and Meta-Analysis

100 citations , July 2018 in “Journal of The American Academy of Dermatology”

This study found that alopecia areata is linked with a higher prevalence of systemic and psychiatric diseases, suggesting that physicians should monitor for these potential comorbidities.

research Alopecia Areata: Treatment Options and Efficacy

182 citations , December 2017 in “Journal of the American Academy of Dermatology”

This article reviews current and emerging treatments for alopecia areata, including Janus kinase inhibitors, highlighting variability in clinical outcomes and the lack of sustained remission.

research Objective Outcome Measures: Collecting Meaningful Data on Alopecia Areata

39 citations , November 2017 in “Journal of The American Academy of Dermatology”

This review presents standardized methods for assessing and tracking hair loss in alopecia areata but reports no clinical results, with the authors noting time limitations in clinical practice.

research Alopecia Areata: Current Situation and Perspectives

34 citations , October 2017 in “Archivos Argentinos De Pediatria”

This review discusses the clinical characteristics, diagnosis, and treatment of alopecia areata, exploring potential environmental, immunological, and genetic factors involved in its development, but reports no new research findings.

research Alopecia Areata: A Comprehensive Review of Pathogenesis and Management

99 citations , July 2017 in “Clinical Reviews in Allergy & Immunology”

This review noted that alopecia areata is an autoimmune disease impacting hair follicles and offered insights into its complex pathogenesis involving immune responses, while highlighting ongoing research into new treatments such as Janus kinase inhibitors and other immunomodulatory drugs.

research SALT II: A New Take on the Severity of Alopecia Tool for Determining Percentage Scalp Hair Loss

44 citations , November 2016 in “Journal of The American Academy of Dermatology”

This article updates a diagnostic tool (SALT II) for assessing hair loss by adding more precise measurements of scalp surface area, particularly useful for various types of alopecia.

research Health-Related Quality of Life Among Patients With Alopecia Areata: A Systematic Review

95 citations , July 2016 in “Journal of The American Academy of Dermatology”

This review concluded that patients with alopecia areata consistently show poor health-related quality of life scores, similar to those in other chronic skin diseases like atopic dermatitis and psoriasis.

research Epidemiology and Burden of Alopecia Areata: A Systematic Review

144 citations , July 2015 in “Clinical, Cosmetic and Investigational Dermatology”

This review reports that alopecia areata affects about 2% of people globally and is linked with psychiatric and medical comorbidities, highlighting its significant disease burden.

research Inhibiting Janus Kinases to Treat Alopecia Areata

52 citations , September 2014 in “Nature medicine”

JAK inhibitors might help treat alopecia areata.