Real-world Burden of Disease and Clinical Characteristics of Alopecia Areata Among Adults in Brazil: Results from a Cross-sectional Survey

INTRODUCTION: Alopecia areata (AA) is an autoimmune disease characterized by patchy or complete nonscarring scalp hair loss (SHL) and is associated with significant psychosocial impacts. Current epidemiologic data on AA in Brazil are sparse, and advanced therapies may be difficult for patients to access. The objective of this study was to assess the real-world burden of disease and unmet need for patients with AA in Brazil. METHODS: This study used data from the Adelphi Real World AA II Brazil Disease Specific Programme™ (DSP), a cross-sectional survey conducted in Brazil (March-June 2024) incorporating retrospective data collection. Participating dermatologists completed patient record forms for their adult patients with AA. Variables assessed included patient demographics, clinical characteristics, treatment goals, prior and current treatments, and issues with current treatments, presented for the overall population, and stratified by extent of SHL and modality of health care access (public vs private health setting). RESULTS: Of the 341 patients included, 22 had 0% SHL, while 84, 95, 46, and 17 had 1-20%, 21-49%, 50-94%, and 95-100% SHL, respectively. More patients with 50-94% SHL had chronic AA versus other SHL groups, and patients with ≥ 50% SHL displayed more severe disease symptoms than those with < 50% SHL. The most common physician-reported goal is to improve current treatment to reduce SHL. Patients with < 50% SHL usually used non-systemic therapies (e.g., topical and intralesional treatments), whereas patients with ≥ 50% SHL reported using non-advanced systemic therapies. Significantly more patients in public settings received topical corticosteroids as their current treatment than in private settings (p = 0.0413). CONCLUSION: The burden of disease associated with AA is underrecognized in Brazil. To achieve the stated treatment goals, there is a need to expand access to advanced therapies that overcome the limitations of traditional therapies.