Comorbid Conditions Associated with Alopecia Areata: A Systematic Review and Meta-analysis

Ly, Sophia; Manjaly, Priya; Kamal, Kanika; Shields, Ali; Wafae, B.; Afzal, Najiba; Drake, Lara; Sanchez, Katherine; Gregoire, S.; Zhou, Guohai; Mita, Carol; Mostaghimi, Arash

doi:10.1007/s40257-023-00805-4

Cited by 7 publications

(2 citation statements)

References 130 publications

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“…Ritlecitinib is a selective dual inhibitor of JAK3 and TEC family kinases and offers a distinct mechanism of action. Furthermore, patients with AA generally have fewer comorbidities (versus patients with RA), and events of serious infections, HZ, MACE, VTE, and malignancies have been reported to occur less frequently in patients with dermatological disorders than with rheumatological diseases [ 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Integrated Safety Analysis of Ritlecitinib, an Oral JAK3/TEC Family Kinase Inhibitor, for the Treatment of Alopecia Areata from the ALLEGRO Clinical Trial Program

King,

Soung,

Tziotzios

et al. 2024

Am J Clin Dermatol

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Background The ALLEGRO phase 2a and 2b/3 studies demonstrated that ritlecitinib, an oral JAK3/TEC family kinase inhibitor, is efficacious at doses of ≥ 30 mg in patients aged ≥ 12 years with alopecia areata (AA). Objective The objective of this study was to evaluate the safety of ritlecitinib in an integrated analysis of four studies in AA. Methods Two cohorts were analyzed: a placebo-controlled and an all-exposure cohort. Proportions and study size–adjusted incidence rates (IRs) of adverse events (AEs) of interest and laboratory abnormalities are reported. Results In the placebo-controlled cohort ( n = 881; median exposure: 169 days), the proportion of ritlecitinib-treated patients with AEs was 70.2–75.4% across doses versus 69.5% in the placebo group; serious AEs occurred in 0-3.2% versus 1.9% for the placebo. A total of 19 patients permanently discontinued due to AEs (5 while receiving the placebo). In the all-exposure cohort ( n = 1294), median ritlecitinib exposure was 624 days [2091.7 total patient-years (PY)]. AEs were reported in 1094 patients (84.5%) and serious AEs in 57 (4.4%); 78 (6.0%) permanently discontinued due to AEs. The most common AEs were headache (17.7%; 11.9/100 PY), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive test (15.5%; 9.8/100 PY), and nasopharyngitis (12.4%; 8.2/100 PY). There were two deaths (breast cancer and acute respiratory failure/cardiorespiratory arrest). Proportions (IRs) were < 0.1% (0.05/100 PY) for opportunistic infections, 1.5% (0.9/100 PY) for herpes zoster, 0.5% (0.3/100 PY) for malignancies (excluding nonmelanoma skin cancer), and 0.2% (0.1/100 PY) for major adverse cardiovascular events. Conclusions Ritlecitinib is well tolerated with an acceptable safety profile up to 24 months in patients aged ≥ 12 years with AA (video abstract and graphical plain language summary available). Trial Registries ClinicalTrials.gov: NCT02974868 (date of registration: 11/29/2016), NCT04517864 (08/18/2020), NCT03732807 (11/07/2018), and NCT04006457 (07/05/2019). Supplementary Information The online version contains supplementary material available at 10.1007/s40257-024-00846-3.

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Section: Discussionmentioning

confidence: 99%

Integrated Safety Analysis of Ritlecitinib, an Oral JAK3/TEC Family Kinase Inhibitor, for the Treatment of Alopecia Areata from the ALLEGRO Clinical Trial Program

King,

Soung,

Tziotzios

et al. 2024

Am J Clin Dermatol

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“…Multiple studies have been conducted to better understand the burden of AA comorbid conditions. Two recent systematic reviews and meta-analyses provided detailed information on the risk of comorbid conditions in patients with AA [ 11 , 12 ]. When compared with controls without AA, these studies have shown that AA is associated with an increased prevalence of various comorbid conditions, especially atopic, autoimmune, and psychiatric disorders.…”

Section: Introductionmentioning

confidence: 99%

Characteristics and Management of Patients with Alopecia Areata and Selected Comorbid Conditions: Results from a Survey in Five European Countries

Vañó-Galván,

Egeberg,

Piraccini

et al. 2024

Dermatol Ther (Heidelb)

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Introduction Alopecia areata (AA) is an autoimmune condition that causes non-scarring hair loss and can impose a high psychosocial burden on patients. The presence of comorbid conditions may impact the management of AA in clinical practice. This analysis aims to describe disease characteristics and management of AA in patients with concomitant atopic, autoimmune, and psychiatric comorbid conditions. Methods Data were collected from the Adelphi Disease Specific Programme™, a cross-sectional survey of physicians and their adult patients with AA conducted in France, Germany, Italy, Spain, and the UK between October 2021 and June 2022. Patients’ disease severity was based on physician’s definition. Physician-reported data on demographics, AA clinical characteristics, comorbid conditions, and information related to AA therapies were analyzed. Analyses were descriptive. Results Overall, 239 dermatologists provided data for 2083 patients, of which 558 patients (27%) had at least one atopic, autoimmune, or psychiatric comorbid conditions. The most common comorbid conditions were atopic dermatitis, autoimmune thyroid disease, and anxiety. The mean (standard deviation) patient age for the three comorbidity groups was 37.6 years (12.1) and 56% of the patients were women ( n = 313). In the three comorbidity groups, 51%, 50%, and 55% of patients with atopic, autoimmune, and psychiatric comorbidities had severe AA with disease progression reported as worsening in 30%, 28%, and 30%, respectively, whereas in the group with no comorbidities, 37% were described as having severe AA and 21% getting worse. Scalp hair loss was the primary sign reported across the three groups of comorbid conditions (atopic, 91%; autoimmune, 91%; psychiatric, 88%). Patients with preselected comorbidities presented more frequently AA-related signs and symptoms beyond scalp hair loss than patients without comorbid conditions. These patients were also more likely to receive topical calcineurin inhibitors, topical immunotherapy, conventional systemic immunosuppressants, and oral Janus kinase inhibitors for the treatment of their AA. Conclusion This analysis provided insights into the burden and management of AA in patients presenting with atopic, autoimmune, and psychiatric comorbid conditions in five European countries.

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Amygdalin ameliorates alopecia areata on C3H/HeJ mice by inhibiting inflammation through JAK2/STAT3 pathway

He,

Liu,

Gong

et al. 2024

Journal of Ethnopharmacology

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Comorbid Conditions Associated with Alopecia Areata: A Systematic Review and Meta-analysis

Cited by 7 publications

References 130 publications

Integrated Safety Analysis of Ritlecitinib, an Oral JAK3/TEC Family Kinase Inhibitor, for the Treatment of Alopecia Areata from the ALLEGRO Clinical Trial Program

Integrated Safety Analysis of Ritlecitinib, an Oral JAK3/TEC Family Kinase Inhibitor, for the Treatment of Alopecia Areata from the ALLEGRO Clinical Trial Program

Characteristics and Management of Patients with Alopecia Areata and Selected Comorbid Conditions: Results from a Survey in Five European Countries

Amygdalin ameliorates alopecia areata on C3H/HeJ mice by inhibiting inflammation through JAK2/STAT3 pathway

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