Hanson Kent A, Austin Jenny, Clayton Nicola, Anderson Peter, Vano-Galvan Sergio, Marwaha Simran, Kurosky Samantha K, Lejeune Alexandre, Piercy James, Law Ernest H
Pfizer Inc, New York, NY, USA.
Department of Pharmacy Systems, Outcomes and Policy, University of Illinois Chicago, Chicago, IL, USA.
Adv Ther. 2025 Jul 21. doi: 10.1007/s12325-025-03302-8.
Alopecia areata (AA) may negatively impact patient quality of life (QoL), disease perception, and work productivity. AA severity is not solely based on scalp hair loss; individuals with AA can experience psychosocial burdens, including emotional symptoms and activity limitations (ES/AL). Our objective was to identify discrete AA severity profiles and evaluate the association with patient-reported outcomes (PROs).
Dermatologist and patient surveys from the Alopecia Areata Disease Specific Programme in France, Germany, Italy, Spain, and the United Kingdom were analyzed. PRO instruments included the Alopecia Areata Patient Priority Outcomes (AAPPO), Work Productivity Activity Index-AA, Skindex-16 AA, Patient Satisfaction with Hair Growth (P-Sat), and Hospital Anxiety and Depression Scale (HADS). Latent class analysis identified distinct classes using the AAPPO hair loss, ES, and AL response options.
A 5-class model was selected. Each class exhibited distinct profiles based on patient-reported hair loss and ES/AL burden: (1) very mild hair loss, very mild ES/AL (n = 175); (2) mild hair loss, mild ES/AL (n = 165); (3) moderate hair loss, very severe ES/AL (n = 111); (4) severe hair loss, moderate ES/AL (n = 52); and (5) very severe hair loss, severe ES/AL (n = 33). Class 3 reported significantly more overall work impairment [β = 16.3 (95% CI, 7.8-24.7)] than class 1. Overall Skindex-16 AA scores were highest for class 3 [β = 38.7 (95% CI, 33.3-44.2)]. Class 3 reported significantly more HADS anxiety [β = 6.0 (95% CI, 4.9-7.0)] and depression [β = 5.7 (95% CI, 4.6-6.9)] than class 1. Across all P-Sat domains, class 5 reported the least satisfaction with therapy.
Generally, patients with more severe patient-reported hair loss and ES/AL had decreased QoL and satisfaction with care and greater work productivity impairment. Although class 3 had moderate patient-reported hair loss, patients experienced the most severe ES/AL burden, suggesting that AA impacts well-being and daily activities in patients with less extensive hair loss.
斑秃（AA）可能会对患者的生活质量（QoL）、疾病认知和工作效率产生负面影响。AA的严重程度并非仅基于头皮脱发情况；AA患者可能会承受心理社会负担，包括情绪症状和活动受限（ES/AL）。我们的目标是确定不同的AA严重程度特征，并评估其与患者报告结局（PROs）之间的关联。
对来自法国、德国、意大利、西班牙和英国的斑秃疾病专项计划中的皮肤科医生和患者调查进行了分析。PRO工具包括斑秃患者优先结局（AAPPO）、工作效率活动指数-AA、Skindex-16 AA、患者对头发生长的满意度（P-Sat）以及医院焦虑抑郁量表（HADS）。潜在类别分析使用AAPPO的脱发、ES和AL反应选项确定了不同的类别。
选择了一个5类模型。每个类别根据患者报告的脱发情况和ES/AL负担呈现出不同的特征：（1）非常轻度脱发，非常轻度ES/AL（n = 175）；（2）轻度脱发，轻度ES/AL（n = 165）；（3）中度脱发，非常严重ES/AL（n = 111）；（4）重度脱发，中度ES/AL（n = 52）；（5）非常重度脱发，重度ES/AL（n = 33）。第3类报告的总体工作受损情况[β = 16.3（95%CI，7.8 - 24.7）]显著高于第1类。第3类的总体Skindex-16 AA得分最高[β = 38.7（95%CI，33.3 - 44.2）]。第3类报告的HADS焦虑[β = 6.0（95%CI，4.9 - 7.0）]和抑郁[β = 5.7（95%CI，4.6 - 6.9）]显著高于第1类。在所有P-Sat领域中，第5类报告对治疗的满意度最低。
一般来说，患者报告的脱发和ES/AL越严重，其生活质量和对护理满意度越低，工作效率受损越严重。虽然第3类患者报告的脱发为中度，但他们经历的ES/AL负担最严重，这表明AA对脱发不太广泛的患者的幸福感和日常活动也有影响。
