Disease burden, clinical management and unmet treatment need of patients with moderate to severe alopecia areata; consensus statements, insights, and practices from CERTAAE (Central/Eastern EU, Russia, Türkiye AA experts) Delphi panel

Lidia Rudnicka; Magdalena Trzeciak; Erkan Alpsoy; Petr Arenberger; Sibel Alper; Nina Benáková; Svetlana Bobko; Murat Borlu; Magdalena Czarnecka Operacz; Burhan Engin; Tülin Ergun; Ilgen Ertam Sağduyu; Olga Filipovská; Aida Gadzhigoroeva; Martina Kojanová; Aleksandra Lesiak; Anna Michenko; Nikolay Murashkin; Nahide Onsun; Witold Owczarek; Zuzana Plzakova; Adam Reich; Marie Selerová; Burcu Aybike Gürbüz

doi:10.3389/fmed.2024.1353354

Disease burden, clinical management and unmet treatment need of patients with moderate to severe alopecia areata; consensus statements, insights, and practices from CERTAAE (Central/Eastern EU, Russia, Türkiye AA experts) Delphi panel

Front Med (Lausanne). 2024 Apr 22:11:1353354. doi: 10.3389/fmed.2024.1353354. eCollection 2024.

Authors

Lidia Rudnicka¹, Magdalena Trzeciak², Erkan Alpsoy³, Petr Arenberger⁴, Sibel Alper⁵, Nina Benáková⁶, Svetlana Bobko⁷, Murat Borlu⁸, Magdalena Czarnecka Operacz⁹, Burhan Engin¹⁰, Tülin Ergun¹¹, Ilgen Ertam Sağduyu¹², Olga Filipovská¹³, Aida Gadzhigoroeva¹⁴, Martina Kojanová⁶, Aleksandra Lesiak¹⁵, Anna Michenko^{7

16

17}, Nikolay Murashkin^{18

19

20

21}, Nahide Onsun²², Witold Owczarek²³, Zuzana Plzakova⁶, Adam Reich²⁴, Marie Selerová²⁵, Burcu Aybike Gürbüz²⁶

Affiliations

¹ Department of Dermatology, Medical University of Warsaw, Warsaw, Poland.
² Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland.
³ Department of Dermatology and Venereology, Akdeniz University School of Medicine, Antalya, Türkiye.
⁴ Department of Dermatovenerology, Third Faculty of Medicine, Charles University, Prague, Czechia.
⁵ Department of Dermatology and Venereology, Koç University, İstanbul, Türkiye.
⁶ Department of Dermatovenereology, First Faculty of Medicine, Charles University, Prague, Czechia.
⁷ Moscow Scientific and Practical Centre of Dermatovenereology and Cosmetology, Moscow, Russia.
⁸ Dermatology and Venereology Department, Erciyes University, Kayseri, Türkiye.
⁹ Department of Dermatology, Medical University of Poznań, Poznań, Poland.
¹⁰ Department of Dermatology and Venerology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, İstanbul, Türkiye.
¹¹ Department of Dermatology, Marmara University, İstanbul, Türkiye.
¹² Department of Dermatology, Ege University, Izmir, Türkiye.
¹³ Department of Dermatology, Masaryk Hospital in Ústí nad Labem, Ústí nad Labem, Czechia.
¹⁴ Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia.
¹⁵ Laboratory of Autoinflammatory, Genetic and Rare Skin Disorders, Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, Lodz, Poland.
¹⁶ Federal State Budgetary Institution of Continuing Professional Education, Central State Medical Academy, Moscow, Russia.
¹⁷ Medical Research and Educational Center, Lomonosov Moscow State University, Moscow, Russia.
¹⁸ National Medical Research Center for Children's Health, Moscow, Russia.
¹⁹ Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
²⁰ Dermatology Department, Federal State Autonomous Institution, Scientific Centre of Children's Health of the Ministry of Health of the Russian Federation, Moscow, Russia.
²¹ Research Institute for Pediatrics and Children's Health Protection, Federal National Public Healthcare Institution "Central Clinical Hospital of the Russian Academy of Sciences", Ministry of Science and Higher Education, Moscow, Russia.
²² Dermatology Department, Bezmialem Vakıf University, İstanbul, Türkiye.
²³ Department of Dermatology, Military Institute of Medicine, Warsaw, Poland.
²⁴ Department of Dermatology, University of Rzeszów, Rzeszów, Poland.
²⁵ Department of Dermatology, Hospital AGEL Novy Jicin, JSC, Novy Jicin, Czechia.
²⁶ Medical Affairs, Pfizer, İstanbul, Türkiye.

Abstract

Objectives: This study aims to update the understanding of Alopecia Areata (AA) in Poland, Czechia, Russia, and Türkiye, focusing on the disease burden, clinical management, and patient journey. It seeks to establish a consensus on optimal management strategies for AA in these regions.

Methods: A modified 2-round Delphi panel was conveyed with 23 Dermatologists (Russia; 4, Türkiye; 7, Poland; 6, and Czechia; 6). The Delphi questionnaire consisted of 61 statements and 43 questions designed to obtain an overall understanding of the perception and acceptance of available information regarding the care of patients with alopecia areata.

Results: The study revealed that moderate-to-severe AA significantly impacts patients' and their families' QoL, consistent with previous studies. AA was found to cause more substantial impairment when additional lesions appeared in visible areas besides the scalp. Work and productivity impairment were notably higher in adults with moderate-to-severe AA. Diagnostic consensus highlighted the importance of skin biopsies and trichoscopy, while the need for more practical severity scoring systems was emphasized. Current treatments, including topical therapies, corticosteroids, and systemic immune modifiers, were deemed insufficient, highlighting the unmet medical need.

Conclusion: The Delphi study underscores a significant disease burden and unmet medical needs in patients with moderate-to-severe AA. It highlights the necessity of access to novel treatments and further research to develop more effective therapies with a tolerable safety profile. The findings align with global research, emphasizing the psychosocial impact of AA and the need for standardized, effective treatment protocols.

Keywords: alopecia areata; clinical management; diagnosis; disease burden; treatment.

Copyright © 2024 Rudnicka, Trzeciak, Alpsoy, Arenberger, Alper, Benáková, Bobko, Borlu, Czarnecka Operacz, Engin, Ergun, Sağduyu, Filipovská, Gadzhigoroeva, Kojanová, Lesiak, Michenko, Murashkin, Onsun, Owczarek, Plzakova, Reich, Selerová and Gürbüz.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was funded by Pfizer. Project management and technical support was provided by Remedium Consulting Group and funded by Pfizer. Pfizer employees did not have any involvement in the achieved consensus nor the decision for journal submission.