Alopecia areata is not a risk factor for heart diseases: A 10-year retrospective cohort study

Lee, Hee Ra; Kim, You Chan; Choi, Jee Woong

doi:10.1371/journal.pone.0250216

Cited by 16 publications

(18 citation statements)

References 27 publications

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“…No increase [27,62,63] Increased; IR 0.93-0.99/100 PY [64,65] Risk of VTE Increased; IR of 0.33-0.79/100 PY [66][67][68][69][70][71][72][73][74] Possibly increased [75][76][77]; o IR 0.18-0.24/ 100 PY [76,77] No increase; IR 0.09/100 PY [77] Increased; IR 0.52-1.85/100 PY [74,[78][79][80] Risk of malignancy Increased [81][82][83]; by 10% overall versus general population [81] (lymphoma SIR 2.46, lung SIR 1.64, melanoma SIR 1.3) [81] Reduced for colorectal cancer (SIR 0.77) [81] and some hormone-dependent cancers No increase, except lymphoma [33,51] p Uncertain [84][85][86] Increased, SIR of 1.14 overall, including lymphoma [87,88] Table 1 Definition of obesity varied across studies [33] e Depending on the definition of hypertension [33] f Depending on the definition of CVD: includes coronary artery disease, myocardial infarction, congestive heart failure, stroke, peripheral vascular disease [33] g…”

Section: Methodsmentioning

confidence: 99%

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A Review of Safety Outcomes from Clinical Trials of Baricitinib in Rheumatology, Dermatology and COVID-19

Bieber

Feist²,

Irvine

et al. 2022

Adv Ther

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Baricitinib is an oral, selective inhibitor of Janus kinase (JAK)1/JAK2 that transiently and reversibly inhibits many proinflammatory cytokines. This mechanism is a key mediator in a number of chronic inflammatory diseases; accordingly, baricitinib has been studied and approved for the treatment of several rheumatological and dermatological disorders, as well as COVID-19. This narrative review summarises and discusses the safety profile of baricitinib across these diseases, with special focus on adverse events of special interest (AESI) for JAK inhibitors, using integrated safety data sets of clinical trial data, and puts findings into context with the underlying risk in the respective disease populations, using supporting literature. We show that rates of infection with baricitinib generally reflected the inherent risk of the disease populations being treated, with serious infections and herpes zoster being more frequent in rheumatic diseases than in dermatological disorders, and herpes simplex being reported particularly in atopic dermatitis. Similarly, rates of major adverse cardiovascular events (MACE), venous thromboembolism (VTE) and malignancies were generally within or below the ranges reported for the respective disease populations, thereby reflecting the underlying risk; these events were therefore more frequent in patients with rheumatic diseases than in those with dermatological disorders, the latter of whom generally had low absolute risk. AESI were usually more common in patients with risk factors specific for each event. When a population similar to that of ORAL Surveillance was considered, the incidence rate of MACE with baricitinib was numerically lower than that reported with tofacitinib and similar to that of tumour necrosis factor inhibitors. No safety concerns were observed in hospitalised patients with COVID-19 who received baricitinib for up to 14 days. Identifying the patterns and likelihoods of AEs that occur during treatment in large groups of patients with different diseases can help the physician and patient better contextualise the benefit-to-risk ratio for the individual patient.

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Section: Methodsmentioning

confidence: 99%

“…The risk of heart disease (heart failure, angina pectoris, acute or chronic MI) does not appear to be increased in patients with AA [ 62 ], although conflicting findings reporting small increases or decreases in risk have been reported (Fig. 1 ; Table 1 ).…”

Section: Adverse Events Of Special Interest: Baricitinib Clinical Evi...mentioning

confidence: 99%

A Review of Safety Outcomes from Clinical Trials of Baricitinib in Rheumatology, Dermatology and COVID-19

Bieber

Feist²,

Irvine

et al. 2022

Adv Ther

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“…All registered and claimed data of the sampled individuals constituted the longitudinal database. The validity and usefulness of the cohort data have been verified in previous studies ( 15 – 19 ).…”

Section: Methodsmentioning

confidence: 52%

No Association Between First Exposure to General Anaesthesia and Atopic Dermatitis in the Paediatric Population

Kim

Choi²,

Lee³

et al. 2022

Acta Derm Venereol

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General anaesthesia could affect various immune responses, including Th1 and Th2 immunity, which might also affect cells that play an important role in the pathogenesis of atopic dermatitis. However, the relationship between general anaesthesia exposure and atopic dermatitis remains unknown. The aim of this study was to investigate the risk of developing atopic dermatitis after first exposure to general anaesthesia in the paediatric population (18 years or under). A retrospective cohort study, including those exposed (n = 7,681) and unexposed (n = 38,405; control participants) to general anaesthesia (1:5 ratio), was conducted using national sample cohort data from 2002 to 2015. All participants were followed up for 2 years after cohort entry. The 2-year cumulative incidences of atopic dermatitis in the exposed and unexposed groups were 2.3% and 2.2%, respectively. In the subgroup analysis by age, the cumulative incidence was not significantly different between these cohorts. The risks of atopic dermatitis were not significant in the exposed group in the univariate model (hazard ratio 1.05; confidence interval 0.88–1.24) and in the multivariate model, wherein all covariates were adjusted (adjusted hazard ratio, 1.03; confidence interval 0.87–1.23). The results suggest that children’s exposure to general anaesthesia was not associated with increased or decreased risk of atopic dermatitis.

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“…A study performed by Kang et al [13] revealed higher incidence rates of stroke during a 3-year follow up period in patients with alopecia areata compared to controls (5.44 vs. 2.75 per 1000 person per year). On the contrary, a 10-year retrospective cohort study by Lee et al [14], which included 3770 patients with alopecia areata and 18,850 controls, revealed no significant differences in the incidence of various cardiovascular diseases between those two groups. Heart failure was reported in 0.3% of patients with alopecia areata and in 0.2% of the healthy controls.…”

Section: Discussionmentioning

confidence: 89%

Chemokine C-C Motif Ligand 7 (CCL7), a Biomarker of Atherosclerosis, Is Associated with the Severity of Alopecia Areata: A Preliminary Study

Waśkiel‐Burnat

Niemczyk

Blicharz

et al. 2021

JCM

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Alopecia areata is an autoimmune, inflammatory form of non-scarring hair loss that may affect any hair-bearing area. Recently, an increased risk of cardiovascular disorders has been described in patients with alopecia areata. The aim of the study was to evaluate the serum concentrations of proinflammatory proteins associated with atherosclerosis (chemokine C-C motif ligand 4; CCL4, chemokine C-C motif ligand 7, CCL7; and sortilin, SORT1), and cardiovascular risk (myeloperoxidase, MPO; interleukin 1 receptor-like 1, IL1RL1; and growth differentiation factor 15, GDF15) in patients with alopecia areata without symptoms or prior cardiovascular disease in comparison with healthy controls. Sixty otherwise healthy patients with alopecia areata and twenty control subjects matched for age, gender, and body mass index (BMI) were enrolled in the study. No significant differences in the serum levels of MPO, IL1RL1, CCL4, CCL7, SORT1, and GDF15 were detected between patients with alopecia areata and healthy controls. A positive correlation was found between the serum concentration of CCL7 and the severity of alopecia areata (r = 0.281, p = 0.03), while GDF15 correlated with age at the disease onset (r = 0.509, p < 0.0001). The results of the present study suggest that the severity of alopecia areata may be associated with an increased risk of atherosclerosis.

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Alopecia areata is not a risk factor for heart diseases: A 10-year retrospective cohort study

Cited by 16 publications

References 27 publications

A Review of Safety Outcomes from Clinical Trials of Baricitinib in Rheumatology, Dermatology and COVID-19

A Review of Safety Outcomes from Clinical Trials of Baricitinib in Rheumatology, Dermatology and COVID-19

No Association Between First Exposure to General Anaesthesia and Atopic Dermatitis in the Paediatric Population

Chemokine C-C Motif Ligand 7 (CCL7), a Biomarker of Atherosclerosis, Is Associated with the Severity of Alopecia Areata: A Preliminary Study

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