斑秃患者的治疗模式和医疗资源利用情况:韩国真实病历回顾。

Ohsang Kwon, Matthew Wallace, Paolo Messina, Agota Szende, Jee Woong Choi, Rachel S Newson, Dong Hyun Koo, Joo Hee Lee
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摘要

斑秃(AA)是一种临床异质性、免疫介导的非瘢痕性脱发疾病。这项真实病历回顾旨在描述韩国严重脱发患者的治疗模式和医疗资源使用情况。我们对 40 名皮肤科医生进行了网络病历审查,审查了 2019 年 5 月至 2021 年 4 月期间被诊断为重度 AA 的 151 名成年患者的病历。从严重疾病诊断之日起至数据收集之日(2022 年 9 月至 11 月),提取了有关患者特征、治疗模式、医疗资源使用和临床结果的匿名数据。66%的患者在初次发病时被诊断为重症,34%的患者在病程中被重新分类为重症。据估计,重症 AA 患者确诊时的平均年龄为 37.1 岁(22-68 岁不等)。53%的患者为男性。大多数患者(93.4%)接受了药物治疗;45.5%的患者接受了≥2个疗程的治疗,平均疗程为24个月。46.0%的患者因疗效不佳而中断一线治疗。71.0%的患者毛发再生,其中59.2%的患者在随访期间毛发再生率大幅提高(≥60%)。头发再生时间的中位数(95% 置信区间)为 13.7(11.0-20.6)个月。每人每年的治疗就诊率从2次(光疗)到10次(局部治疗)不等,皮肤科医生的就诊率为每人每年12.9次,6.0%的患者因斑秃而住院。大多数住院治疗都与治疗有关,而且都发生在接受脉冲全身皮质类固醇治疗的患者身上。在韩国,AA 给患者和经济造成的负担很重,而对于常用治疗策略的有效性,严重 AA 患者的需求仍未得到满足。
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Treatment patterns and healthcare resource utilization among patients with alopecia areata: A real-world chart review in South Korea.

Alopecia areata (AA) is a clinically heterogeneous, immune-mediated, non-scarring hair loss disorder. This real-world chart review sought to characterize treatment patterns and healthcare resource use among patients with severe AA in South Korea. A web-based chart review of 40 dermatologists was conducted in which the medical charts of 151 adult patients diagnosed with severe AA between May 2019 and April 2021 were reviewed. Anonymized data on patient characteristics, treatment patterns, healthcare resource use, and clinical outcomes were extracted from the date of severe disease diagnosis until the date of data collection (September-November 2022). Sixty-six percent of patients were diagnosed with severe disease at initial presentation, while 34% were re-classed to severe during the disease course. Mean estimated patient age at the time of diagnosis of severe AA was 37.1 (range 22-68) years. Fifty-three percent of patients were male. Most patients (93.4%) received pharmacological treatment for their condition; 45.5% received ≥2 lines of treatment with a mean duration of 24 months. First-line treatment discontinuation due to lack of efficacy occurred in 46.0% of cases. Hair regrowth occurred in 71.0% of patients, 59.2% of whom experienced major regrowth (≥60%) during the follow-up period. Median (95% confidence interval) time to regrowth was 13.7 (11.0-20.6) months. Treatment visit rates per person-year ranged from two (phototherapy) to 10 (topical treatment), dermatologist visits occurred at a rate of 12.9 per person-year and 6.0% of patients were hospitalized due to alopecia areata. The majority of hospitalizations were related to treatment and occurred in patients who received pulse systemic corticosteroid therapy. The patient and economic burden of AA in South Korea is high and there remains a critical unmet need among patients with severe AA with respect to the effectiveness of commonly used treatment strategies.

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