P67 Overall lifetime risk for alopecia areata is 2.1% and is higher in women, non-White ethnic groups and the most deprived: a UK population-based cohort study

Abstract

Abstract Alopecia areata (AA) is an immune-mediated nonscarring alopecia often associated with substantial morbidity. However, there are limited population-based data on potential disparities in the burden of AA, including across different ethnicities and sociodemographic classifications. We aimed to provide the first large-scale, population-based evaluation of lifetime risk of AA across sociodemographic subgroups. This study used routinely collected data from a large UK population-based database: the Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC). All children and adults registered with general practices contributing to the RCGP RSC network in the period 2009–2018 without a prior diagnosis of AA were included. People were considered to develop AA if they had an AA diagnosis and, in the subsequent 365 days, no code for an alternative diagnosis (e.g. traction alopecia and scarring alopecia). The cumulative lifetime risk of AA was estimated at age 80 years using survival models, with age as the timescale and accounting for the competing risk of death. Lifetime risk was calculated for the whole population and by sociodemographic subgroups comprising sex, major UK ethnicity groups and socioeconomic deprivation. In a total population of 4 052 231, 6961 developed new-onset AA. The lifetime risk in the overall population was 2.11% [95% confidence interval (CI) 2.06–2.16]. There was substantial difference in lifetime risk of AA by ethnicity; lifetime risk was 1.74% (95% CI 1.68–1.80) in the White subgroup, 5.87% (95% CI 5.51–6.24) in Asian, 3.03% (95% CI 2.63–3.42) in Black, 4.44% (95% CI 3.50–5.37) in mixed and 4.47% (95% CI 3.63–5.31) in other ethnic groups. Females had a higher lifetime risk of AA than males: 2.35% (95% CI 2.28–2.43) vs. 1.88% (95% CI 1.81–1.94). Lifetime risk was greater with increasing socioeconomic deprivation: least-deprived 1.68% (95% CI 1.59–1.78) vs. most-deprived quintile 2.92% (95% CI 2.77–3.07). Our findings demonstrate that AA affects nearly 1 in 50 people over a lifetime. Lifetime risk is substantially greater in people of non-White ethnicity and is highest in those of Asian ethnicity (one in 17 people). The lifetime risk is also higher in females and those with the greatest socioeconomic deprivation. Clinicians should be aware of the disproportionate distribution of AA across the population and support the provision of healthcare resource to groups with the highest burden. Funding sources: this research was sponsored by Pfizer. Project management, medical writing and statistical support were provided by Momentum Data, UK, and were funded by Pfizer.