Alopecia areata (AA) is a common immune-mediated non-scarring alopecia often associated with substantial morbidity. There are however, limited population-based data on potential disparities in the burden of AA, including across people of different ethnicities and deprivation. We aimed to provide the first large-scale, population-based estimate of lifetime risk of AA overall and by important sociodemographic subgroups. As AA is associated with an increased burden of mental health conditions and work-related outcomes (unemployment, time off work), a detailed understanding of the burden of disease in different sociodemographic groups is vital to plan resource provision.
The overall purpose of the study is to provide an estimate of the cumulative lifetime incidence of AA in the population overall and by important sociodemographic groups. Moreover, to do a subgroup analysis in the AA population to identify health-related disparities across people in different socioeconomic strata, geographical distribution, sex and ethnic groups. The disparities that will be considered are AA associated: Mental health conditions; healthcare utilisation; and work impact (time off work and unemployment). The cumulative lifetime risk of AA was estimated at age 80 years (approximate life expectancy in the UK) using survival models, with age as the timescale and accounting for the competing risk of death. The assessment of any associations with baseline characteristics and the outcomes of interest will be assessed using Cox proportional hazards models (time to event outcomes) and Poisson regression (repeated event outcomes) models.
Study Type
OBSERVATIONAL
Enrollment
4,052,231
Observational analysis of usual care only.
Momentum Data Limited
London, United Kingdom
Likelihood of Depressive Episodes
Estimated using logistic regression and reported using adjusted odds ratios
Time frame: Data was collected retrospectively, assessed prior to and up to two years following initial Alopecia Areata diagnosis for each participant
Likelihood of Recurrent Major Depressive Disorder
Estimated using logistic regression and reported using adjusted odds ratios
Time frame: Data was collected retrospectively, assessed prior to and up to two years following initial Alopecia Areata diagnosis for each participant
Likelihood of Anxiety Disorder
Estimated using logistic regression and reported using adjusted odds ratios
Time frame: Data was collected retrospectively, assessed prior to and up to two years following initial Alopecia Areata diagnosis for each participant
Relative Incidence of Primary Care Attendances
Estimated using negative binomial regression and reported as adjusted incidence rate ratio
Time frame: Data was collected retrospectively, assessed up to two years following initial Alopecia Areata diagnosis for each participant
Relative Incidence of Dermatology Referrals
Estimated using Cox proportional hazard regression and reported as Adjusted hazard ratio
Time frame: Data was collected retrospectively, assessed up to two years following initial Alopecia Areata diagnosis for each participant
Relative Incidence Psychological Therapy
Estimated using Cox proportional hazard regression and reported as adjusted hazard ratio
Time frame: Data was collected retrospectively, assessed up to two years following initial Alopecia Areata diagnosis for each participant
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Relative Incidence of Unemployment
Unemployment identified by issue of IB113 or ESA113 forms for unemployment. Relative incidence estimated using Cox proportional hazard regression and reported as Adjusted hazard ratio
Time frame: Data was collected retrospectively, assessed up to two years following initial Alopecia Areata diagnosis for each participant
Relative Incidence of Time Off Work
Time off work identified by recorded issue of Med 3 certificate in primary care. Relative incidence estimated using Cox proportional hazard regression and reported as Adjusted hazard ratio
Time frame: Data was collected retrospectively, assessed up to two years following initial Alopecia Areata diagnosis for each participant