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Corticosteroids for the Treatment of Alopecia Areata in the United States
According to a study published in JAMA Dermatology, corticosteroids were the most commonly used treatment for adults with alopecia areata (AA) within the United States between 2015 and 2020.
Researchers aimed to analyze treatment patterns among adults with AA in the United States from 2015 to 2020. The study utilized data from the IBM MarketScan Research Database, focusing on commercially insured individuals aged 18 or older who were newly treated for AA during the period from October 15, 2015, to February 28, 2020. Patients were identified as having AA based on relevant diagnosis codes and were required to have continuous health plan enrollment for at least 1 year before and after their cohort entry date, with no AA diagnosis codes in the year preceding cohort entry.
The study cohort included 45 483 individuals with a mean age of 43.8 years, with a majority being female (65.7%). During the year of follow-up after diagnosis, 66.4% of patients received at least one AA treatment. The most common treatments were intralesional corticosteroids (41.8%), topical corticosteroids (40.9%), intramuscular corticosteroids (38.1%), and oral corticosteroids (20.6%). Patients with more severe forms of AA, such as alopecia totalis or alopecia universalis, showed distinct treatment patterns, with a lower frequency of intralesional steroid use and a higher frequency of topical corticosteroid use. Notably, almost half of the patients (47.2%) did not receive any treatment on the day of diagnosis, and by 12 months, the majority (71.8%) were no longer receiving any AA treatment, making them the largest group.
“At 365 days after diagnosis, more than two-thirds of patients were no longer receiving any AA treatment,” the authors stated, “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 online September 20, 2023. doi:10.1001/jamadermatol.2023.3109