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斑秃的治疗模式与满意度:欧洲一项真实世界横断面调查的结果

Alopecia Areata Treatment Patterns and Satisfaction: Results of a Real-World Cross-Sectional Survey in Europe.

作者信息

Anderson Peter, Piercy James, Austin Jenny, Marwaha Simran, Hanson Kent A, Law Ernest H, Schaefer Gregor, Kurosky Samantha K, Vañó-Galván Sergio

机构信息

Adelphi Real World, Bollington, UK.

Pfizer Inc, New York, NY, USA.

出版信息

Dermatol Ther (Heidelb). 2024 Dec;14(12):3243-3258. doi: 10.1007/s13555-024-01280-3. Epub 2024 Oct 16.

Abstract

INTRODUCTION

Alopecia areata (AA) is an autoimmune disease that causes scalp, face, and/or body hair loss. Recently, oral treatments with kinases inhibition became the first approved therapies for severe AA. An understanding of the use and effectiveness of traditional therapies in real-world treatment settings is needed to guide integration of novel therapies into the treatment paradigm. This study aimed to describe traditional treatment patterns, dermatologists' reasons for therapy choice, and dermatologists' satisfaction with disease control among patients with AA.

METHODS

Data were drawn from the 2021-2022 Adelphi Real World AA Disease Specific Programme™, a cross-sectional survey of dermatologists and adult patients with AA, conducted in France, Germany, Italy, Spain, and the UK. For each patient, using data from patient consultation and medical records, dermatologists reported % scalp hair loss (SHL), characteristics of current and prior AA therapies, and satisfaction with disease control.

RESULTS

Overall, 239 dermatologists provided data for 1720 patients with AA. Mean (SD) patient age was 35.8 (11.6) years, and 51% were male. Based on dermatologist perception, among patients with ≤ 10% SHL, 74% were experiencing mild AA, while ≥ 95% of patients with ≥ 50% SHL were experiencing severe/very severe AA. In patients with ≥ 50% SHL, the most common therapies received included systemic immunosuppressants (31%), topical corticosteroids (24%), and oral corticosteroids (24%). Among all patients who had switched therapies, 49%, 26%, and 24% switched because of worsening AA, lack of initial efficacy with prior treatment, and loss of response over time, respectively. Among those with SHL ≥ 50%, dermatologists reported satisfaction with current therapy in < 30% of patients.

CONCLUSION

Dermatologists reported low satisfaction with traditional AA therapies used in patients with extensive SHL, with some patients discontinuing treatment because of worsening disease. This suggests more effective treatments are needed for patients with severe AA.

摘要

引言

斑秃(AA)是一种自身免疫性疾病,可导致头皮、面部和/或身体毛发脱落。最近,激酶抑制的口服治疗成为首个获批用于重度斑秃的疗法。为了指导将新疗法整合到治疗模式中,需要了解传统疗法在实际治疗环境中的使用情况和有效性。本研究旨在描述重度斑秃患者的传统治疗模式、皮肤科医生的治疗选择原因以及皮肤科医生对疾病控制的满意度。

方法

数据来自2021 - 2022年阿德尔菲真实世界斑秃疾病特定项目™,这是一项在法国、德国、意大利、西班牙和英国对皮肤科医生和成年斑秃患者进行的横断面调查。对于每位患者,皮肤科医生利用患者咨询和病历数据,报告头皮脱发百分比(SHL)、当前和既往斑秃治疗的特征以及对疾病控制的满意度。

结果

总体而言,239名皮肤科医生为1720名斑秃患者提供了数据。患者的平均(标准差)年龄为35.8(11.6)岁,51%为男性。根据皮肤科医生的判断,在SHL≤10%的患者中,74%患有轻度斑秃,而在SHL≥50%的患者中≥95%患有重度/极重度斑秃。在SHL≥50%的患者中,最常用的治疗方法包括全身免疫抑制剂(31%)、外用皮质类固醇(24%)和口服皮质类固醇(24%)。在所有更换治疗方法的患者中,分别有49%、26%和24%是因为斑秃病情恶化、既往治疗初期无效以及随着时间推移失去疗效而更换。在SHL≥50%的患者中,皮肤科医生报告对当前治疗的满意度低于30%。

结论

皮肤科医生报告对广泛SHL患者使用的传统斑秃疗法满意度较低,一些患者因病情恶化而停止治疗。这表明重度斑秃患者需要更有效的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c484/11604861/e0682c904584/13555_2024_1280_Fig1_HTML.jpg

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