OBJECTIVES: Alopecia areata (AA) is a chronic autoimmune condition estimated to affect approximately 2% of people worldwide. The disease can have a substantial impact on quality of life and mental health, particularly for women. As novel systemic treatments become available, a better understanding of patients and their management is needed.

METHODS: Data were derived from the OM1 Dermatology Network (OM1, Inc; Boston, MA), a multi-source real-world data (RWD) network with linked healthcare claims, social determinants of health (SDoH), and EMR data for U.S. patients managed by dermatologists. Index date was set by the first encounter with an AA diagnosis code during the study period (01/2013 - 12/2022). Patient demographics, insurance type, education, and household income were assessed at index. Major depressive disorder (MDD) and generalized anxiety disorder (GAD) were defined by the presence of at least 2 outpatient diagnosis codes ≥30 days apart or one inpatient diagnosis code. Medications were identified by prescriptions, administrations and/or fills and procedures by procedure codes.

RESULTS: The study included 39,941 patients (67% female, mean age at index 40 years), 19,543 (49%) of whom had linked SDoH. Of the 77% with race available, the breakdown was 73% white, 16% black, 6% asian and 5% other. MDD and GAD were diagnosed in 8.1% and 10.9% of patients, respectively. Most common treatments were topical corticosteroids (63%) and intralesional triamcinolone acetonide (60%). Trends in management over time and in patient subsets were also explored.

CONCLUSIONS: In this cohort of dermatologist-managed AA patients, there was a higher proportion of women compared to the literature. Prevalence of diagnosed MDD was similar to the reported prevalence in U.S. adults, but GAD was higher (8.6% MDD and 2.7% GAD, NIMH Jan 2022). With new treatment options, tracking trends in disease and comorbidity burden in real-world care will be critical to understanding potential effects on quality of life.