PracticeUpdate Conference Series: IID 2018

Alopecia areata carries a substantial mental health burden V ivek Singam, BLA, of the Feinberg School of Medicine at Northwestern University in Chicago, explained that alopecia areata can be distressing psychologically and can impair quality of life. Studies of mental health comorbidities of alopecia areata, however, are limited. Dr. Singam and colleagues sought to identify mental health disorders and emergencies associated with alopecia areata. They examined data from the National Inpatient Sample, which includes an approx- imately 20% sample of all US hospitalizations (n=87,053,155 admissions). They constructed multivariable logistic regression models with each mental health condition as the dependent variable and alopecia areata, as well as age, sex, race/ethnicity, and insurance status as independent variables. Overall, 1167 children and adults were identified with an inpatient diagnosis of alopecia areata. Alopecia areata was significantly associated with any mental health disorder (adjusted odds ratio 2.292, 95% CI 1.974–2.661). These disorders included: ƒ ƒ Attention deficit hyperactivity disorder and conduct disorders (8.109, 95% CI 5.162–12.739) ƒ ƒ Impulse control disorders (4.946, 95% CI 1.601–15.275) ƒ ƒ Adjustment disorders (4.795, 95% CI 2.586–8.889) ƒ ƒ Developmental disorders (4.345, 95% CI 2.748–6.869) ƒ ƒ Personality disorders (3.815, 95% CI 2.282–6.370) ƒ ƒ Suicide or intentional self-inflicted injury (2.773, 95% CI 1.659–4.634) ƒ ƒ Substance abuse (2.585, 95% CI 1.973–3.385) ƒ ƒ Anxiety disorders (2.456, 95% CI 1.905–3.165) ƒ ƒ Mood disorders (2.178, 95% CI 1.805–2.628) ƒ ƒ Psychotic disorders (2.063, 95 % CI 1.375–3.097) ƒ ƒ History of mental health disorder or substance abuse (1.718, 95% CI 1.415–2.085) ƒ ƒ Alcohol abuse (1.479, 95% CI 1.052–2.080) ƒ ƒ Other mental health disorders (2.914, 95% CI 1.717–4.946) Alopecia areata was not associated with cognitive or pediatric mental health disorders. Dr. Singam concluded that strong associations were shown between alopecia areata and mental health disorders and emergencies in this cohort of hospitalized patients. Studies are needed to address the causes and ideal interventions for mental health disorders surrounding alopecia areata.

sore throat, headache, and rhinorrhea. Exposure increased dose-proportionally with an accumulation of approximately 40–60% and approximately 10–20% with once weekly and once every other week dosing, respectively. BNZ-1 elimination half-life was approxi- mately 4–5 days. BNZ-1 was associated with exposure- dependent decreases in Tregs (interleukin 2), natural killer cells (interleukins 2 and 15), and CD8-positive central memory T cells (interleukin 15) as measured by flow cytometry of peripheral bloodmononuclear cells. Tregs and central memory T cells reached maximum reduction at day 29. Natural killer cells dropped initially and tended to recover by day 29 except in the 1.5 mg once-weekly and 3 mg every- other-week cohorts. T cells, B cells, and monocytes were unaffected. Dr. Frohna concluded that the favorable safety and potent pharmacodynamic activity of BNZ-1 support the planned phase II trial in patients with moderate to severe alopecia areata.

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IID 2018 • PRACTICEUPDATE CONFERENCE SERIES