Treatment Preferences of Adults and Adolescents With Alopecia Areata

In a recent study published in the Journal of Dermatology, patients with alopecia areata (AA) in the United States and Europe are more likely to accept substantial risks to obtain an effective treatment.

Researchers aimed to gauge the treatment preferences of both adult (≥18 years) and adolescent (12–17 years) patients with AA in the United States and Europe, specifically regarding the trade-offs they would make between the potential benefits and risks associated with Janus kinase (JAK) inhibitor therapy, which has demonstrated efficacy in promoting hair regrowth in individuals with AA. The researchers utilized a discrete choice experiment involving 12 tasks, in which patients were presented with hypothetical treatment alternatives, including benefits such as an 80% to 100% probability of scalp hair regrowth and achieving moderate to normal eyebrow and eyelash hair. Treatment-related risks considered were the 3-year probabilities of serious infection, cancer, and blood clots. The study included 201 adults and 120 adolescents.

Results showed that the most critical attribute for both adults and adolescents was a 50% probability of achieving hair regrowth on most or all of the scalp, with adolescents placing relatively greater importance on this factor. Adults expressed aversion to the risks of serious infection, cancer, and blood clots, whereas adolescents were particularly averse to the risk of cancer. In exchange for a 20% increase in the probability of 80% to 100% scalp hair regrowth, adults were willing to accept 3-year risks of 7.4% for serious infection, 2.5% for cancer, and 9.3% for blood clots. Adolescents, on the other hand, were willing to accept a 3.3% risk of cancer.

The study concludes that patients with AA in the United States and Europe are willing to accept considerable risks to access an effective AA treatment, providing valuable insights for drug approval and patient-centered treatment decisions.

Reference
Tervonen T, Whichello C, Law E, et al. Treatment preferences of adults and adolescents with alopecia areata: a discrete choice experiment. J Dermatol. Published online December 12, 2023. doi:10.1111/1346-8138.17056