Awareness of rising alopecia prevalence may aid burden of disease analyses

Alopecia prevalence and incidence rates increased between 2016 and 2019, a trend that may be reflective of a growing disease burden or simply due to more patients seeking care, according to a study.

Regardless, in their retrospective, population-based cohort study, Arash Mostaghimi, MD, MPA, MPH, of Brigham and Women’s Hospital, Harvard University, Boston, and colleagues found that knowing the contemporary prevalence and incidence of alopecia areata (AA), alopecia totalis (AT) and alopecia universalis (AU) could benefit future burden of disease analyses.

“Living with AA can be associated with reduced quality of life, social functioning, and psychological well-being, with substantial costs to patients and health care systems,” Mostaghimi and colleagues wrote.

The most recent nationwide AA prevalence estimate, conducted in 2020, relied heavily on self-reported AA via an online survey. The researchers determined an alternative data collection approach using insurance claims-based analyses may yield more accurate results.

Mostaghimi and colleagues analyzed the annual prevalence and incidence of alopecia areata AA and AT/AU among adults and children in the United States.

Data was collected from IBM MarketScan commercial claims and encounters and Medicare supplemental databases from January 2015 to December 2019, comprising more than 25 million patients annually.

Eligible patients included 18,368 in 2016, 14,372 in 2017, 14,231 in 2018 and 13,455 in 2019.

Results showed that AA prevalence increased from 2016 (0.199%; 95% CI, 0.198%-0.2%) to 2019 (0.222%; 95% CI, 0.221%-0.223%). The range of overall incidence of AA per 100,000 person-years was 87.39 (95% CI, 86.84-87.96) in 2017 to 92.9 (95% CI, 92.35-93.45) in 2019, according to the study.

Of prevalence and incidence cases, researchers found that roughly 5% to 10% were AT/AU. Additionally, AT/AU prevalence rose from 0.012% (95% CI, 0.012%-0.013%) in 2016 to 0.019% (95% CI, 0.018%-0.019%) in 2019. However, incidence of AT/AU was much lower than AA, with 7.09 (95% CI, 6.94-7.25) individuals experiencing signs and symptoms in 2017 and 8.92 (95% CI, 8.75-9.09) experiencing them in 2016.

Regardless of age, AA prevalence rates were higher among women compared with men. Additionally, prevalence among adults was much higher than among children and adolescents (range: 0.22%-0.245% vs. 0.12%-0.135%). The researchers also found that Northeast residents were also disproportionately affected compared with those living in other regions (range: 0.273%-0.305% vs. 0.155%-0.222%).

The authors conclude that the slight increase in AA cases may reflect either a growing burden of disease or simply an increased proportion of patients seeking care.

“Taken together, this study highlights contemporary trends in the annual prevalence and incidence of AA and AT/AU over time among a large, real world U.S. population, which may help to inform future analyses of the burden of disease,” Mostaghimi and colleagues wrote.