Peter Anderson

Introduction Ritlecitinib, an oral, selective dual inhibitor of Janus kinase (JAK) 3 and tyrosine kinase expressed in hepatocellular carcinoma (TEC) family kinases, is approved for treating severe alopecia areata (AA) in patients aged ≥ 12 years in the USA. This study describes characteristics, treatment satisfaction, and success among adults initiating ritlecitinib. Methods A sample of US dermatologists treating adults who received ritlecitinib for severe AA were surveyed between November 2023 and June 2024. Demographics, clinical characteristics, treatment history, satisfaction, and health-related quality of life were analyzed overall, among recent initiators, and stratified by treatment duration. Results A total of 123 adults were included (mean age 37.1 years; 57% male; 79% white; 88% commercial insurance). Mean disease duration was 2.1 years. At ritlecitinib initiation (n = 93), mean scalp hair loss was 71% and 73% had worsening AA. The proportion of patients with hair regrowth increased with longer treatment duration, 49% among those with < 3 months of treatment (n = 18/37) to 82% with > 6 months (n = 28/34). Physicians reported many recent initiators (n = 26) felt moderate/severe embarrassment (84%), frustration (73%), and anxiety (65%) due to their AA. Among patients with available data (n = 102), ritlecitinib was the first AA treatment for 46%. Treatment goals (n = 123) included reducing hair loss (94%), improving quality-of-life (41%), and achieving long-term control (32%). Reasons for selecting ritlecitinib (n = 113) included its ability to reduce scalp hair loss (38%), cost–benefit ratio (28%), and safety profile (25%). Satisfaction with AA control was 54%, 68%, and 85% after < 3 (n = 20/37), 3–6 (n = 27/40), and > 6 months (n = 29/34), respectively, of ritlecitinib treatment. Conclusions Many patients experienced psychological burden due to their AA around the start of treatment. Ritlecitinib was chosen for its efficacy, safety, and cost-effectiveness. Hair regrowth, disease stability, and treatment satisfaction increased with longer ritlecitinib treatment duration suggesting sustained treatment is important for achieving treatment goals.

Atopic dermatitis (AD) is a relapsing, chronic inflammatory skin condition characterized by intense itching and eczematous lesions. AD is common in pediatric patients, but treatment options are limited for these patients and data on treatment patterns are scarce. This study aimed to descriptively evaluate treatments used in pediatric AD and physician- and patient-reported perspectives of available options in real-world practice in Japan. Data were drawn from the Adelphi Real World Pediatric and Adolescent AD Disease Specific Programme™, a cross-sectional survey, with retrospective data collection, of physicians and patients in Japan from July to December 2022. Physicians completed patient record forms for their next 3-10 consecutively consulting patients, collecting data on demographics and clinical characteristics, treatment regimens, and perceptions around treatment choice and satisfaction. Patients/caregivers also provided their perceptions on treatment choice and satisfaction. Analyses were descriptive. Overall, 55 physicians provided data for 537 pediatric patients, with 111 patients/caregivers also reporting data. The patient population was 63.3% (n = 340) male, and mean ± standard deviation age was 12.6 ± 4.2 years, with 54.0% (n = 290) of patients classified as pediatric (aged ≤ 14 years) and 46.0% (n = 247) adolescent (aged 15-17 years). Patient treatments included topical corticosteroids (TCS; 89.1%, n = 457/513), biologics (12.3%, n = 63/513), oral JAK-is (7.6%, n = 39/513), and immunosuppressants (1.8%, n = 9/513). Physicians reported that they believe better control could be achieved in 64.8% (n = 332) of patients compared with 93.1% (n = 81) of patients self-reporting this. TCS was the most common treatment in pediatric AD management, in agreement with the current guideline recommendation. Overall, most physicians and patients believed that better control could be achieved. However, in mild patients, most patients believed better control could be achieved, while physicians did not. This suggests that views of disease control, and desire for improved disease control, may differ between physicians and patients.

Introduction Alopecia areata (AA) is an autoimmune disease characterized by nonscarring hair loss that may impact quality of life (QoL). After 2021, new therapies were approved to treat severe AA in Taiwan; however, there is no global definition of severe AA. Dermatologists may use other criteria in addition to scalp hair loss (SHL) when estimating severity. This study evaluates the impact of AA on patient QoL and how dermatologists assessed disease severity and managed AA in Taiwan prior to availability of new therapies. Methods Dermatologists completed the Adelphi Real World AA Disease Specific Programme™ cross-sectional survey. Each provided their perspective on assessing AA severity and available AA treatments, and information on patients consulting with AA. Results were analyzed descriptively and stratified by dermatologist-assessed AA severity. Results Fifty dermatologists reported median (interquartile range) SHL of 45% (31–51%) and 76% (51–90%) as typical of “severe” and “very severe” AA, respectively, based on 285 patients. Multiple factors were considered, including SHL, disease duration, and prior treatment responses. Mean (SD) time on current therapy was 8.3 (13.0) months. Patients with severe/very severe disease received varied first- and second-line treatments and had more severe QoL impacts, including anxiety/worry, depression, and impairments in daily life and activities. Most dermatologists felt confident in diagnosing AA; however, few were satisfied with treatment options for patients with severe AA. Conclusions Dermatologists in Taiwan did not define AA disease severity solely based on extent of SHL, and many felt there was an unmet need for effective treatments for severe disease.

Introduction This study aimed to explore the relationship between atopic dermatitis (AD) disease severity and impact on patients and to describe AD treatment patterns and barriers to treatment in Brazil and Colombia. Methods Data were drawn from the Adelphi AD Disease Specific Programme™, a cross-sectional survey of physicians and their patients with AD, conducted in Brazil and Colombia between May 2022 and July 2023. Physicians provided data on demographics, clinical characteristics, treatments, and reasons for not prescribing targeted therapy (TT). Patients completed various patient-reported outcome (PRO) questionnaires: Patient-Oriented Eczema Measure, Dermatology Life Quality Index, EuroQol five-dimensional, and Work Productivity and Activity Impairment. Data were analysed descriptively. Comparisons between current severity were made using analysis of variance (ANOVA) or Kruskal–Wallis tests. Results Overall, 100 physicians provided data for 624 adult patients with AD from Brazil (n = 328) and Colombia (n = 296): 47% currently mild, 43% moderate, and 10% severe. For all the PRO measures analysed in Colombia and for the majority in Brazil, the impact on patients increased with increasing disease severity (p < 0.05). In total, 85% of patients with AD in Brazil and 73% in Colombia were treated with topical therapies, with 51% in Brazil and 77% in Colombia receiving systemic therapies, which included biologics (Brazil 12%; Colombia 33%) and oral Janus kinase inhibitors (Brazil 5% and Colombia 10%). The main barriers to TT in Brazil were patients being unable to pay for treatment and treatment not being covered by health insurance. In Colombia, the main barriers were formulary restrictions and patients being very recently diagnosed. Conclusions Increased AD disease severity was associated with a greater patient impact and reduced quality of life, with healthcare costs and formulary restrictions hindering optimal treatment across Brazil and Colombia.