Table 5.
Results regarding treatment preferences and management.
| Item | Consensus % |
|---|---|
| Treatment | |
| The primary goal of the treatment in a patient diagnosed with AA is to achieve a cure. | 95.6 |
| In the event that curative treatment is impossible, stopping further hair loss and stimulating the regrowth of hair are primary goals. | 100 |
| In the event that curative treatment is impossible, improving the QoL is also a primary goal of AA treatment. | 91.3 |
| PUVA does not provide an optimal efficacy-safety balance in AA treatment; therefore, it should not be used. | 72.7 |
| Topical corticosteroids should be the first-line treatment irrespective of disease severity and disease phase in children up to 12 years of age. | 73.8 |
| Topical calcineurin inhibitors (TCIs) have lower efficacy than topical corticosteroids in alopecia areata. | 91.3 |
| Systemic corticosteroids should only be used to temporarily halt disease progression in patients with rapidly progressing, widespread, active disease. | 100 |
| Systemic corticosteroids (SCS) alone or in combination with local corticosteroids should be the first-line treatment for children over 12 years of age with active severe AA. (Systemic corticosteroids only as a temporary measure to contain rapidly progressing active disease). | 72.7 |
| SCS alone or in combination with local corticosteroids should be the first-line treatment for adults with active severe AA. (Systemic corticosteroids only as a temporary measure to contain rapidly progressing active disease). | 81.8 |
| ILC injections alone or in combination with local corticosteroids should be the first-line treatment for adults with active mild AA and/or AA with mild isolated patches of hair loss. | 81.8 |
| ILC injections alone or in combination with local/systemic corticosteroids should be the first-line treatment for adults with active moderate AA. (Systemic corticosteroids only as a temporary measure to contain rapidly progressing active disease). | 81.8 |
| ILC injections are more effective than ultrapotent/potent topical steroids for inducing regrowth and durable remission. | 82.6 |
| Topical minoxidil and topical anthralin can be used in between topical corticosteroids and topical immunotherapy | 78.2 |
| Topical immunotherapy should be the first-line treatment for children over 12 years of age with AA in chronic phases who do not respond o topical corticosteroid treatments regardless of disease severity. | 81.8 |
| Topical immunotherapy should be the first-line treatment for adults with AA in chronic phases who do not respond to topical corticosteroid treatments regardless of disease severity. | 72.7 |
| Steroid-sparing agents such as cyclosporine, AZA, and methotrexate should only be used to mitigate the risk of adverse effects associated with prolonged use of systemic corticosteroids. | 73.9 |
| JAK inhibitor (with or without SCS) can be initiated as a first-line systemic treatment in children over 12 years old with moderate-to-severe AA in whom the disease could not be controlled with optimal topical/local therapies. (From a scientific perspective assuming JAK inhibitor treatment is available and reimbursed for this condition for your patients.) | 90.9 |
| JAK inhibitor (with or without SCS) can be initiated as a first-line systemic treatment in adults with moderate-to-severe AA in whom the disease could not be controlled with optimal topical therapies. (From a scientific perspective assuming JAK inhibitor treatment is available and reimbursed for this condition for your patients.) | 73.9 |
| Efficient systemic treatment started at an early stage may prevent the development of disease-specific comorbidities in AA. | 73.9 |
| Common observations, perspectives, and practices* | % |
|---|---|
| Patient journey insight items from different country settings | |
| The specialty/ies most commonly provide/s long-term follow-up for child patients with mild AA Dermatology. | 86.9 |
| The specialty/ies, most commonly provide/s long-term follow-up for child patients with moderate–severe AA; Dermatology. | 100 |
| The specialty/ies most commonly provide/s long-term follow-up for adult patients with mild AA: Dermatology. | 100 |
| The specialty/ies, most commonly provide/s long-term follow-up for adult patients with moderate to severe AA: Dermatology. | |
| AA is an under-treated disease in my country. | 100 |
| Clinical practice insight items from different country settings. | |
| The treatment guidelines I follow to treat my AD patients: EADV**(Türkiye equally follows AAD). | 70.3 |
| Systemic corticosteroids (SCS) or Cyclosporin (CyC) with or without SCS are the first-line systemic treatments that I generally use for adult patients with moderate–severe AA despite optimal local/topical therapies** (Türkiye and Poland above 80%, other countries have different approaches within the country). | 72.7 |
| Clinical response, duration of remission, and side effects are the most important factors which affect my systemic treatment preference in AA. | 100 |
*More than 70% of the total participants and of the participants in each country chose the same answer.
**Variation between countries, the total response is still over 70%. AA, alopecia areata; EADV, European Academy of Dermatology and Venereology; AAD, American Academy of Dermatology; SCS, Systemic Corticosteroids; CyC, Cyclosporine; ILC, intralesional corticosteroids.