Brigham and Women's Hospital, Harvard University, Boston, Massachusetts.
AbbVie Inc, North Chicago, Illinois.
JAMA Dermatol. 2024 Sep 1;160(9):945-952. doi: 10.1001/jamadermatol.2024.2404.
Alopecia areata (AA) has been associated with multiple comorbidities, yet information regarding the timing of comorbidity development after AA diagnosis is limited.
To evaluate the prevalence and new-onset incidence of psychiatric and autoimmune comorbidities in patients with AA in the US.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort analysis used data collected from January 1, 2007, to April 30, 2023, from the Merative MarketScan Research Databases, which contains medical and drug claims data from more than 46 million patients in the US. Data from adolescent and adult patients (aged 12-64 years) diagnosed with AA and patients without AA (ie, controls) were evaluated. For some analyses, patients with AA were matched (1:4) to controls based on sex, age, and geographic region.
Prevalence (at the time of AA diagnosis) and incidence (new onset after AA diagnosis) of psychiatric and autoimmune diseases were reported as percentage of patients. Risk of developing a new-onset psychiatric or autoimmune disease after AA diagnosis was calculated as adjusted hazard ratios (AHRs) with 95% CIs.
At baseline, 63 384 patients with AA and 3 309 107 without AA were identified. After matching, there were 16 512 and 66 048 patients in the AA and control groups, respectively, with a mean (SD) age of 36.9 (13.4) years and 50.6% of whom were female. Compared with the unmatched controls, patients with AA had higher prevalence of psychiatric (30.9% vs 26.8%; P < .001) and autoimmune (16.1% vs 8.9%; P < .0001) comorbidities at AA diagnosis; incidence was also higher in patients with AA (without history of these comorbidities) vs the matched control group. Patients with AA vs controls had a significantly higher risk of developing a psychiatric (AHR, 1.3; 95% CI, 1.3-1.4) or autoimmune (AHR, 2.7; 95% CI, 2.5-2.8) comorbidity.
In this cohort study, patients with AA had a higher prevalence of autoimmune and psychiatric comorbidities at AA diagnosis and demonstrated an elevated risk of new-onset autoimmune and psychiatric comorbidities after their diagnosis. These data highlight the most common comorbidities among patients with AA and may help physicians counsel and monitor patients newly diagnosed with AA.
斑秃（AA）与多种合并症相关，但关于 AA 诊断后合并症发展时间的信息有限。
评估美国 AA 患者中精神和自身免疫合并症的患病率和新发病例发生率。
设计、地点和参与者：这项回顾性队列分析使用了 2007 年 1 月 1 日至 2023 年 4 月 30 日从 Merative MarketScan Research Databases 收集的数据，该数据库包含来自美国超过 4600 万患者的医疗和药物索赔数据。评估了诊断为 AA 和没有 AA（即对照）的青少年和成年患者的数据。在某些分析中，根据性别、年龄和地理位置，将 AA 患者（1:4）与对照匹配。
报告了 AA 诊断时（即诊断时）的患病率（精神病和自身免疫疾病）和（AA 诊断后新发病例）的发病率（新发病例），以患者百分比表示。AA 诊断后发生新发精神病或自身免疫疾病的风险作为调整后的危险比（AHR）及其 95%置信区间（CI）计算。
在基线时，确定了 63384 名患有 AA 和 3309107 名未患有 AA 的患者。匹配后，AA 组和对照组分别有 16512 名和 66048 名患者，平均（SD）年龄为 36.9（13.4）岁，其中 50.6%为女性。与未匹配的对照组相比，AA 患者的精神病（30.9% vs 26.8%；P<.001）和自身免疫（16.1% vs 8.9%；P<.0001）合并症的患病率更高；AA 患者（无这些合并症病史）的发病率也更高。与对照组相比，AA 患者发生精神病（AHR，1.3；95%CI，1.3-1.4）或自身免疫（AHR，2.7；95%CI，2.5-2.8）合并症的风险显著更高。
在这项队列研究中，AA 患者在 AA 诊断时自身免疫和精神病合并症的患病率更高，并在诊断后表现出自身免疫和精神病合并症新发病例的风险增加。这些数据突出了 AA 患者最常见的合并症，并可能有助于医生为新诊断为 AA 的患者提供咨询和监测。
