P33 A population-based study describing the burden of disease in patients with vitiligo and on the healthcare system in the UK

Abstract

Abstract The prevalence of vitiligo is estimated to be between 0.5% and 2.0% globally, with marked geographical differences. Patients with vitiligo may be burdened by comorbidities and a lack of satisfactory treatment. UK evidence on the vitiligo-associated burden of disease and healthcare resource utilization is lacking. Patients aged ≥ 12 years with vitiligo were identified using data from UK administrative healthcare databases (Clinical Practice Research Datalink; Hospital Episode Statistics database). The incidence of vitiligo and point prevalence on 1 January was calculated annually between 2010 and 2021. The rate of dermatology-related primary and secondary care events and the percentage of patients receiving vitiligo-related treatments were calculated for the 5 years after diagnosis. Time to treatment following diagnosis was analysed using Kaplan–Meier curves. Of 17 239 patients with vitiligo, the overall mean incidence was 0.164 (range 0.096–0.188) per 1000 person-years between 2010 and 2021; prevalence was 0.30% (range 0.21–0.38%). Comorbidities (recorded after vitiligo) included diabetes (19.4%), eczema (8.9%), thyroid disease (7.5%) and rheumatoid arthritis (6.9%); mental health comorbidities (recorded before or after vitiligo) included anxiety/depression (24.6%), depression (18.5%) and anxiety (16.0%). General practitioner consultations per 1000 person-years reduced from 979 in the first year after diagnosis to ≤ 65 in years 2–5 after diagnosis. Outpatient dermatology-related hospital events per 1000 person-years decreased from 1019 in the first year to 569 in the third year and then appeared to remain stable. In the first year after diagnosis, 61% of patients did not receive any vitiligo-related treatment (e.g. topical steroids, topical calcineurin inhibitors, oral steroids and phototherapy), increasing to 82% from the second year onwards; 85% of prevalent patients (2019) did not receive any vitiligo-related treatment. The median time from diagnosis to first treatment (incident cohort) was 34 months. The prevalence of vitiligo (0.3%) reported here is comparable to recent UK estimates (0.3%) representing patients seeking medical care. The incidence of vitiligo remained stable between 2010 and 2019, reducing from 2020 following the onset of the COVID-19 pandemic. Diabetes, rheumatoid arthritis, thyroid disorders and mental health comorbidities (consistent with reports from others) indicate a burden in seeking care for comorbidities in addition to the health needs of vitiligo. The majority of patients not on vitiligo-related treatment within a year of diagnosis, and the length of time to first treatment, suggest a gap in effective therapeutic options and early treatment for vitiligo. New effective treatment options, early treatment initiation and psychological intervention are needed to reduce the burden of vitiligo. Funding sources: Incyte Corporation.