Unmet treatment needs for alopecia areata
Unmet treatment needs for alopecia areata
In this video, Lynn Wilks, a patient with alopecia areata, discusses unmet patient needs for this condition and three key things she wants clinicians to do differently when discussing management for alopecia areata.
Watch Lynn's full interview here
Unmet treatment needs for alopecia areata
There is no cure for alopecia areata (AA), and there is an unmet need for long-term effective and tolerable treatments for managing this condition. One indicator of this unmet need is patient dissatisfaction with current therapies for AA1.
As surveyed by dermatologists in the US, common reasons for patient dissatisfaction with treatments for AA are as follows1:
- Lack of treatment efficacy (73%)
- AA impacting patient quality of life (50%)
- Slow onset of action (37%)
- Patient not satisfied (33%)
Patient dissatisfaction is greater in relation to more severe AA (17% satisfaction), due to poor or failed hair regrowth following treatment, and the adverse impact of AA on patient quality of life (Figure 1)1.
Figure 1. Patient attitudes towards treatment options for alopecia areata (Adapted1).
A consequence of this unmet need is that patients with AA are frequently switched from one treatment to another, due to poor or no effective response (Figure 2)1.
Figure 2. Patients switch treatments for alopecia areata frequently in the absence of hair regrowth following therapy (Adapted1). *‘Other’ includes soralen and ultraviolet radiation A, ultraviolet radiation A, panretinal photocoagulation, vitamins, minoxidil, finasteride, iron, bimatoprost or simvastatin/ezetimibe.
Common reasons for severe AA patient dissatisfaction are the side effects of oral corticosteroids (40%) and the mode of administration with immunomodulators (25%)1. Overall dissatisfaction with treatment is prominent (14% dissatisfied, 29% neutral), and increases with AA severity (Figure 3)1.
Figure 3. Patient attitudes about current alopecia areata (AA) treatments by AA severity and overall (total) (Adapted1).
Responding to unmet needs: FDA approval of baricitinib for severe AA
In 2022, the U.S. Food and Drug Administration (FDA) approved the Janus kinase (JAK) inhibitor baricitinib oral tablet for adults with severe or very severe AA2,3, following completion of the pivotal clinical trials BRAVE-AA1 and BRAVE-AA24-6.
In BRAVE-AA1 (N = 654 enrolled), 22.8% (n = 184) of patients on 2 mg baricitinib and 38.8% (n = 281) of patients on 4 mg baricitinib achieved a SALT score of 20 or less at Week 36, compared with 6.2% in the placebo group (n = 189)6.
In BRAVE-AA2 (N = 546 enrolled), 19.4% (n = 156) of patients who received 2 mg baricitinib and 35.9% (n = 234) of patients on 4 mg baricitinib achieved a SALT score of 20 or less at Week 36, compared with 3.3% of patients on placebo (n = 156)6.
In BRAVE-AA1 and BRAVE-AA2, the most common side effects associated with baricitinib were upper respiratory tract infection, headache, acne, high cholesterol (hyperlipidaemia), increase of creatinine phosphokinase and urinary tract infection6.
Baricitinib is not indicated for combined use with other JAK inhibitors, biologic immunomodulators, cyclosporine or other immunosuppressants3.
Continue to the next section to learn about more drugs for AA under clinical trial investigation.
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Developed by EPG Health. This content has been developed independently of the sponsor, Pfizer, who has reviewed the content only for scientific accuracy. EPG Health received funding from the sponsor in order to help provide healthcare professionals with access to the highest quality medical and scientific information, education and associated relevant content.