RESUMO
Alopecia areata (AA) is a chronic autoimmune disease that causes non-scarring hair loss. Data are lacking on the epidemiology and clinical and economic burden of AA in Spain. To estimate the prevalence and incidence of AA in Spain and describe sociodemographic and clinical characteristics, treatment patterns, healthcare resource utilization (HCRU) and associated costs. This was an observational, retrospective, descriptive study based on the Health Improvement Network (THIN®) database (Cegedim Health Data, Spain). Patients with ICD9-Code 704.01 for AA, registered between 2014 and 2021, were identified. Prevalence (%) and incidence rates per 1,000 patient-years (IR) of AA were calculated and clinical characteristics, treatment characteristics and HCRU/costs were assessed. A total of 5,488 patients with AA were identified. The point prevalence of AA in 2021 was 0.44 (95% confidence interval [CI]: 0.43-0.45) overall, 0.48 (0.47-0.49) in adults, and 0.23 (0.21-0.26) in children ≤12 years. The 2021 IR for AA in adults was 0.55 (0.51-0.60). Of 3,351 adults with AA, 53.4% were female, mean (standard deviation [SD]) age was 43.1 (14.7) years, and 41.6% experienced comorbidities. Among adults, 2.7% used systemic treatment (0.5% immunosuppressants, 2.5% oral corticosteroids, 0.3% both). Laboratory tests and health care professional visits were the principal drivers of cost, which was 821.2 (1065.6)/patient in the first year after diagnosis. The epidemiology of AA in Spain is comparable with that reported for other countries, being more prevalent among adults. There is a significant burden of comorbidities and cost for patients, with limited use of systemic treatments, suggesting an unmet treatment need in this population.
Assuntos
Alopecia em Áreas , Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Humanos , Espanha/epidemiologia , Alopecia em Áreas/epidemiologia , Alopecia em Áreas/economia , Estudos Retrospectivos , Feminino , Masculino , Adulto , Prevalência , Criança , Custos de Cuidados de Saúde/estatística & dados numéricos , Incidência , Pessoa de Meia-Idade , Adolescente , Adulto Jovem , Pré-Escolar , Imunossupressores/uso terapêutico , Imunossupressores/economia , IdosoRESUMO
Alopecia areata (AA) is managed with prolonged medical treatments and cosmetic therapies, whose cost can be burdensome. We sought to identify the costs of AA treatment and consolidate the available data for the practicing dermatologist by performing a PubMed search of articles indexed for MEDLINE. Ten studies including approximately 16,000 patients with AA across a range of Oxford Centre for Evidence-Based Medicine Levels of Evidence were included. Studies showed that despite the limited efficacy of many AA therapies, patients incurred substantial expenses to manage their AA.
Assuntos
Alopecia em Áreas , Efeitos Psicossociais da Doença , Alopecia em Áreas/economia , Alopecia em Áreas/terapia , Alopecia em Áreas/tratamento farmacológico , Humanos , Custos de Cuidados de Saúde/estatística & dados numéricos , Dermatologistas/economia , Fármacos Dermatológicos/economia , Fármacos Dermatológicos/administração & dosagem , Fármacos Dermatológicos/uso terapêuticoAssuntos
Alopecia em Áreas , Análise Custo-Benefício , Medicamentos Genéricos , Piperidinas , Pirimidinas , Pirróis , Humanos , Piperidinas/uso terapêutico , Piperidinas/efeitos adversos , Piperidinas/economia , Alopecia em Áreas/tratamento farmacológico , Alopecia em Áreas/economia , Pirimidinas/economia , Pirimidinas/uso terapêutico , Pirimidinas/efeitos adversos , Estudos Retrospectivos , Medicamentos Genéricos/economia , Medicamentos Genéricos/efeitos adversos , Medicamentos Genéricos/uso terapêutico , Feminino , Masculino , Adulto , Resultado do Tratamento , Pirróis/economia , Pirróis/uso terapêutico , Pirróis/efeitos adversos , Inibidores de Proteínas Quinases/efeitos adversos , Inibidores de Proteínas Quinases/economia , Inibidores de Proteínas Quinases/uso terapêutico , Pessoa de Meia-Idade , Adulto JovemRESUMO
BACKGROUND: This real-world analysis aimed at characterizing patients hospitalized for alopecia areata (AA) in Italy, focusing on comorbidities, treatment patterns and the economic burden for disease management. METHODS: Administrative databases of healthcare entities covering 8.9 million residents were retrospectively browsed to include patients of all ages with hospitalization discharge diagnosis for AA from 2010 to 2020. The population was characterized during the year before the first AA-related hospitalization (index-date) and followed-up for all the available successive period. AA drug prescriptions and treatment discontinuation were analyzed during follow-up. Healthcare costs were also examined. RESULTS: Among 252 patients with AA (mean age 32.1 years, 40.9% males), the most common comorbidities were thyroid disease (22.2%) and hypertension (21.8%), consistent with literature; only 44.4% (112/252) received therapy for AA, more frequently with prednisone, triamcinolone and clobetasol. Treatment discontinuation (no prescriptions during the last trimester) was observed in 86% and 88% of patients, respectively at 12 and 24-month after therapy initiation. Overall healthcare costs were 1715 per patient (rising to 2143 in the presence of comorbidities), mostly driven by hospitalization and drugs expenses. CONCLUSIONS: This first real-world description of hospitalized AA patients in Italy confirmed the youth and female predominance of this population, in line with international data. The large use of corticosteroids over other systemic therapies followed the Italian guidelines, but the high discontinuation rates suggest an unmet need for further treatment options. Lastly, the analysis of healthcare expenses indicated that hospitalizations and drugs were the most impactive cost items.
Assuntos
Alopecia em Áreas , Hospitalização , Humanos , Itália/epidemiologia , Alopecia em Áreas/epidemiologia , Alopecia em Áreas/economia , Alopecia em Áreas/terapia , Masculino , Feminino , Adulto , Estudos Retrospectivos , Hospitalização/economia , Hospitalização/estatística & dados numéricos , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Criança , Custos de Cuidados de Saúde/estatística & dados numéricos , Comorbidade , Pré-Escolar , Doenças da Glândula Tireoide/epidemiologia , Doenças da Glândula Tireoide/economia , Doenças da Glândula Tireoide/terapia , Hipertensão/epidemiologia , Hipertensão/tratamento farmacológico , Hipertensão/economia , IdosoRESUMO
Previous QOL and disease burden studies have not captured all relevant aspects of living with alopecia areata (AA). To better understand the burden and everyday experience of living with moderate-to-severe AA, a cross-sectional, online, quantitative-qualitative survey was developed to assess symptoms, relationships, productivity, treatments, and financial burden. Adult patients were recruited from the National Alopecia Areata Foundation database. Data were analyzed descriptively. A total of 216 patients completed the survey. Most were female (83%), aged ≥45 years (59%), and white (78%). Nearly 2 of 3 respondents (62%) made different major life decisions (regarding relationships, education, or career) owing to AA. Most respondents (85%) stated coping with AA as a daily challenge, citing mental health issues, concealing hair loss, and others' reactions; 47% reported anxiety and/or depression. Many patients (75%) persistently concealed hair loss (mean time spent, 10.3 h/wk). Treatment discontinuation was common owing to lack of efficacy, side effects, and cost. Associated expenditures included buying wigs or hairpieces and psychotherapy (mean â¼$2,000/y each). Survey respondents comprised a self-selected sample, which may not reflect the entire population. The impact of AA extends beyond cosmetic concerns and carries a considerable psychosocial burden. Efficacious, less burdensome AA treatments are needed to regrow hair and alleviate psychosocial sequelae.