Alopecia areata (AA) is an autoimmune condition that leads to patchy, nonscarring hair loss. The etiology still remains unknown, and the condition can be debilitating for patients, impacting their psychosocial wellbeing. Various triggers have been reported ranging from genetic predispositions, infections, and environmental factors. Medications have also been thought to be an inciting factor in AA. Using the FDA adverse event reporting system (FAERS), all cases reporting AA as an adverse event were used to capture associated medications and patient characteristics. Descriptive statistics were conducted along with logistic regression analysis using patient sex as the primary outcome. There were 1,331 AA cases reported as an adverse event with medication use. With regards to the top 10 medications, 29.2% of AA cases were seen with docetaxel, 8.3% were with adalimumab, 4.7% with trastuzumab, 4.4% with cyclophosphamide, 4.3% with infliximab, 4.1% with carboplatin, 3.4% with dupilumab, 2.7% with levonorgestrel, 2.6% with etanercept, and 2.6% with from pertuzumab. Monoclonal antibodies accounted for 6 out of the top 10 drugs with the highest number of AA cases. Males were more likely to report AA when taking adalimumab (OR 1.79, p = 0.04) and dupilumab (OR 2.56, p = 0.03) compared to females. Individuals between 42-64 years old accounted for 46.7% of AA cases. Lastly, females in older age groups showed greater odds of experiencing AA compared to males (OR 1.03, p < 0.01). Based on the FAERS, there has been a steady rise in AA cases and monoclonal antibodies were the most frequently cited medication class tied to AA. Given the dearth of literature and many unanswered questions surrounding AA, our novel large dataset study highlights the most associated medications, identifies an increase in reported cases over the years, and captures age/sex related demographic trends. An awareness of notable medications and patient demographics adds granularity to the spectrum of potential AA triggers and may increase a provider’s index of suspicion to improve clinical outcomes in the future.

A Cross-Sectional Analysis of Medications Used by Patients Reporting Alopecia Areata on the FDA Adverse Event Reporting System

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