The Alopecia Areata Severity and Morbidity Index (ASAMI) Study: Results from a Global Expert Consensus Exercise on Determinants of Alopecia Areata Severity
Issued Date
2024-01-01
Resource Type
ISSN
21686068
eISSN
21686084
Scopus ID
2-s2.0-85184806333
Pubmed ID
38324292
Journal Title
JAMA Dermatology
Rights Holder(s)
SCOPUS
Bibliographic Citation
JAMA Dermatology (2024)
Suggested Citation
Moussa A., Bennett M., Wall D., Meah N., York K., Bokhari L., Asfour L., Rees H., Abraham L.S., Asz-Sigall D., Basmanav F.B., Bergfeld W., Betz R.C., Bhoyrul B., Blume-Peytavi U., Callender V., Chitreddy V., Combalia A., Cotsarelis G., Craiglow B., Dhurat R., Donovan J., Doroshkevich A., Eisman S., Farrant P., Ferrando J., Gadzhigoroeva A., Green J., Grimalt R., Harries M., Hordinsky M., Irvine A., Jolliffe V., Kaiumov S., King B., Lee J., Lee W.S., Li J., Lortkipanidze N., McMichael A., Mesinkovska N.A., Messenger A., Mirmirani P., Olsen E., Orlow S.J., Ovcharenko Y., Piraccini B.M., Pirmez R., Rakowska A., Reygagne P., Rudnicka L., Corralo D.S., Senna M., Shapiro J., Sharma P., Siliuk T., Starace M., Suchonwanit P., Takwale A., Tosti A., Vañó-Galván S., Visser W.I., Vogt A., Wade M., Yip L., Zhou C., Sinclair R. The Alopecia Areata Severity and Morbidity Index (ASAMI) Study: Results from a Global Expert Consensus Exercise on Determinants of Alopecia Areata Severity. JAMA Dermatology (2024). doi:10.1001/jamadermatol.2023.5869 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/97247
Title
The Alopecia Areata Severity and Morbidity Index (ASAMI) Study: Results from a Global Expert Consensus Exercise on Determinants of Alopecia Areata Severity
Author(s)
Moussa A.
Bennett M.
Wall D.
Meah N.
York K.
Bokhari L.
Asfour L.
Rees H.
Abraham L.S.
Asz-Sigall D.
Basmanav F.B.
Bergfeld W.
Betz R.C.
Bhoyrul B.
Blume-Peytavi U.
Callender V.
Chitreddy V.
Combalia A.
Cotsarelis G.
Craiglow B.
Dhurat R.
Donovan J.
Doroshkevich A.
Eisman S.
Farrant P.
Ferrando J.
Gadzhigoroeva A.
Green J.
Grimalt R.
Harries M.
Hordinsky M.
Irvine A.
Jolliffe V.
Kaiumov S.
King B.
Lee J.
Lee W.S.
Li J.
Lortkipanidze N.
McMichael A.
Mesinkovska N.A.
Messenger A.
Mirmirani P.
Olsen E.
Orlow S.J.
Ovcharenko Y.
Piraccini B.M.
Pirmez R.
Rakowska A.
Reygagne P.
Rudnicka L.
Corralo D.S.
Senna M.
Shapiro J.
Sharma P.
Siliuk T.
Starace M.
Suchonwanit P.
Takwale A.
Tosti A.
Vañó-Galván S.
Visser W.I.
Vogt A.
Wade M.
Yip L.
Zhou C.
Sinclair R.
Bennett M.
Wall D.
Meah N.
York K.
Bokhari L.
Asfour L.
Rees H.
Abraham L.S.
Asz-Sigall D.
Basmanav F.B.
Bergfeld W.
Betz R.C.
Bhoyrul B.
Blume-Peytavi U.
Callender V.
Chitreddy V.
Combalia A.
Cotsarelis G.
Craiglow B.
Dhurat R.
Donovan J.
Doroshkevich A.
Eisman S.
Farrant P.
Ferrando J.
Gadzhigoroeva A.
Green J.
Grimalt R.
Harries M.
Hordinsky M.
Irvine A.
Jolliffe V.
Kaiumov S.
King B.
Lee J.
Lee W.S.
Li J.
Lortkipanidze N.
McMichael A.
Mesinkovska N.A.
Messenger A.
Mirmirani P.
Olsen E.
Orlow S.J.
Ovcharenko Y.
Piraccini B.M.
Pirmez R.
Rakowska A.
Reygagne P.
Rudnicka L.
Corralo D.S.
Senna M.
Shapiro J.
Sharma P.
Siliuk T.
Starace M.
Suchonwanit P.
Takwale A.
Tosti A.
Vañó-Galván S.
Visser W.I.
Vogt A.
Wade M.
Yip L.
Zhou C.
Sinclair R.
Author's Affiliation
University Hospitals Sussex NHS Foundation Trust
David Tvildiani Medical University
Ramathibodi Hospital
Faculty of Biology, Medicine and Health
Peking University People's Hospital
Yonsei University Mirae Campus
Medical University of Warsaw
Universitat Internacional de Catalunya
Permanente Medical Group
Wake Forest University School of Medicine
Universitätsklinikum Bonn
Hospital Clinic Barcelona
Massachusetts General Hospital
University of Minnesota Twin Cities
National Skin Centre, Singapore
Alma Mater Studiorum Università di Bologna
V. N. Karazin Kharkiv National University
University of Melbourne
Charité – Universitätsmedizin Berlin
IRCCS Azienda Ospedaliero-Universitaria di Bologna
NYU Grossman School of Medicine
Hospital Universitario Ramón y Cajal
University of Miami Leonard M. Miller School of Medicine
Barts and The London School of Medicine and Dentistry
Cleveland Clinic Foundation
Yale School of Medicine
Lokmanya Tilak Municipal General Hospital
Trinity College Dublin
Eastern Health
The University of British Columbia
Salford Royal NHS Foundation Trust
Netcare
UCI School of Medicine
University College Dublin
University of Pennsylvania Perelman School of Medicine
Hospital General "Dr. Manuel Gea González"
Hôpital Saint-Louis
Harvard Medical School
Salford Royal Hospital
The University of Sheffield
Stellenbosch University
St. Vincent's Hospital Melbourne
Clinic of Trichology and Cosmetology Nautilus
Indian Journal of Dermatology Venereology Leprosy
St Helens & Knowsley National Health Service Trust
Sinclair Dermatology
Hair Treatment and Transplantation Center
Skin Partners Specialist Dermatologists
#TricoHRC Research Group
Hair Restoration Blackrock
Australasian Hair and Wool Research Society
The London Skin and Hair Clinic
Moscow Research and Medical Center of Dermatology and Cosmetology
Skin Health Institute
Callender Dermatology and Cosmetic Center
Inst. de Dermatologia Professor Rubem David Azulay da Santa Casa de Misericordia do Rio de Janeiro
Duke Dermatology Clinic
Hospital Regional da Asa Norte
David Tvildiani Medical University
Ramathibodi Hospital
Faculty of Biology, Medicine and Health
Peking University People's Hospital
Yonsei University Mirae Campus
Medical University of Warsaw
Universitat Internacional de Catalunya
Permanente Medical Group
Wake Forest University School of Medicine
Universitätsklinikum Bonn
Hospital Clinic Barcelona
Massachusetts General Hospital
University of Minnesota Twin Cities
National Skin Centre, Singapore
Alma Mater Studiorum Università di Bologna
V. N. Karazin Kharkiv National University
University of Melbourne
Charité – Universitätsmedizin Berlin
IRCCS Azienda Ospedaliero-Universitaria di Bologna
NYU Grossman School of Medicine
Hospital Universitario Ramón y Cajal
University of Miami Leonard M. Miller School of Medicine
Barts and The London School of Medicine and Dentistry
Cleveland Clinic Foundation
Yale School of Medicine
Lokmanya Tilak Municipal General Hospital
Trinity College Dublin
Eastern Health
The University of British Columbia
Salford Royal NHS Foundation Trust
Netcare
UCI School of Medicine
University College Dublin
University of Pennsylvania Perelman School of Medicine
Hospital General "Dr. Manuel Gea González"
Hôpital Saint-Louis
Harvard Medical School
Salford Royal Hospital
The University of Sheffield
Stellenbosch University
St. Vincent's Hospital Melbourne
Clinic of Trichology and Cosmetology Nautilus
Indian Journal of Dermatology Venereology Leprosy
St Helens & Knowsley National Health Service Trust
Sinclair Dermatology
Hair Treatment and Transplantation Center
Skin Partners Specialist Dermatologists
#TricoHRC Research Group
Hair Restoration Blackrock
Australasian Hair and Wool Research Society
The London Skin and Hair Clinic
Moscow Research and Medical Center of Dermatology and Cosmetology
Skin Health Institute
Callender Dermatology and Cosmetic Center
Inst. de Dermatologia Professor Rubem David Azulay da Santa Casa de Misericordia do Rio de Janeiro
Duke Dermatology Clinic
Hospital Regional da Asa Norte
Corresponding Author(s)
Other Contributor(s)
Abstract
Importance: Current measures of alopecia areata (AA) severity, such as the Severity of Alopecia Tool score, do not adequately capture overall disease impact. Objective: To explore factors associated with AA severity beyond scalp hair loss, and to support the development of the Alopecia Areata Severity and Morbidity Index (ASAMI). Evidence Review: A total of 74 hair and scalp disorder specialists from multiple continents were invited to participate in an eDelphi project consisting of 3 survey rounds. The first 2 sessions took place via a text-based web application following the Delphi study design. The final round took place virtually among participants via video conferencing software on April 30, 2022. Findings: Of all invited experts, 64 completed the first survey round (global representation: Africa [4.7%], Asia [9.4%], Australia [14.1%], Europe [43.8%], North America [23.4%], and South America [4.7%]; health care setting: public [20.3%], private [28.1%], and both [51.6%]). A total of 58 specialists completed the second round, and 42 participated in the final video conference meeting. Overall, consensus was achieved in 96 of 107 questions. Several factors, independent of the Severity of Alopecia Tool score, were identified as potentially worsening AA severity outcomes. These factors included a disease duration of 12 months or more, 3 or more relapses, inadequate response to topical or systemic treatments, rapid disease progression, difficulty in cosmetically concealing hair loss, facial hair involvement (eyebrows, eyelashes, and/or beard), nail involvement, impaired quality of life, and a history of anxiety, depression, or suicidal ideation due to or exacerbated by AA. Consensus was reached that the Alopecia Areata Investigator Global Assessment scale adequately classified the severity of scalp hair loss. Conclusions and Relevance: This eDelphi survey study, with consensus among global experts, identified various determinants of AA severity, encompassing not only scalp hair loss but also other outcomes. These findings are expected to facilitate the development of a multicomponent severity tool that endeavors to competently measure various disease impact. The findings are also anticipated to aid in identifying candidates for current and emerging systemic treatments. Future research must incorporate the perspectives of patients and the public to assign weight to the domains recognized in this project as associated with AA severity..