Dermatologists’ Perspectives and Real-World Assessment of Alopecia Areata Severity, Burden, and Healthcare Resource Utilization in Adults in the Kingdom of Saudi Arabia

INTRODUCTION: Alopecia areata (AA), an autoimmune disease, causes hair loss on the scalp, face, and body, with a prevalence of approximately 2% in the Middle East. AA is associated with significant impacts to patient quality of life (QoL). This study described dermatologist perceptions and experiences treating AA in the Kingdom of Saudi Arabia (KSA) while new treatments were introduced, and examined patient disease burden and unmet treatment need. METHODS: Data were analyzed from the Adelphi Real World AA Disease Specific Programme™, conducted September 2022-March 2023. Dermatologists rated their agreement with statements on diagnosing/managing AA and provided clinical and treatment information for four patients (mild/moderate AA: one each; severe/very severe AA: two). A subset of these patients completed the SKINDEX-16, Hospital Anxiety and Depression Scale (HADS), and the Work Productivity and Activity Impairment-AA (WPAI-AA) questionnaires. Analyses were stratified by percent scalp hair loss (SHL). RESULTS: A total of 50 dermatologists and 185 patients were included. Most dermatologists reported severe AA was difficult to treat owing to lack of effective therapies. A median of 51.5% SHL was reported as typical of severe AA. Impact of AA on patient QoL was the most frequently reported factor informing disease severity. Overall, 52.4% of patients had severe or very severe AA (as assessed by their physician). Approximately one-third of patients had abnormal anxiety and depression scores as measured by HADS. Patients with ≤ 20% SHL generally had lower mean Skindex-16 scores (impact of AA on QoL). Patients with ≥ 50% SHL reported greater work and activity impacts on the WPAI-AA. Most patients were receiving their first AA treatment, with the most common treatments differing by SHL category. Healthcare resource utilization and costs were greater among patients with ≥ 50% SHL. CONCLUSIONS: In the KSA, the burden of AA extends beyond SHL to include both mental health and economic burdens, highlighting the need for effective treatments.