OBJECTIVES: The objective of this research was to characterize real-world treatment patterns among alopecia areata (AA) patients in diverse healthcare delivery settings in the United States.

METHODS: Patients from 6 specialty dermatology networks and 4 integrated delivery networks within the OMNY Health Database with any indication of AA (diagnosis code: L63*) from 2012-2021 were included. Demographic characteristics were tabulated at first AA diagnosis. Percentages of patients with prescriptions/procedures for any of the following first and second-line therapy classes were computed and tabulated by year: intralesional corticosteroids (ILCS), topical corticosteroids (TCS), topical immunotherapy (TI), oral prednisone, and anthralin.

RESULTS: Across 2012-2021, a total of 32,766 AA patients and 245,507 associated encounters were included. Distributions of gender (60% female), race (67% White, 16% Black, 17% Other among known categories), age (19% ≥ 61 years, 64% 21-61 years, 15% < 21 years) were as expected. ILCS was the most common treatment observed, ranging in frequency between 46% to 60%, peaking in 2013. TCS prescriptions ranged from 14% to 23% with increasingly higher percentages (20 – 23%) observed over 2018-2021. Oral prednisone prescriptions ranged from 0.1% - 1.1%, peaking in 2015. TI and anthralin usage were both negligible over the observation period.

CONCLUSIONS: Results provide insights into real-world treatment patterns for AA within a diverse set of US healthcare settings. ILCS and TCS were by far the most common therapies, with increased prescription of TCS observed over recent years. As new treatments are developed and introduced, future analyses would be helpful to understand uptake of therapies and prescription patterns among AA patients.