Innovative Trials are passionate about ensuring our diverse population is adequately represented within medical research. Whether it is wanting to see more people from underrepresented communities choosing science as a career and pushing for greater patient diversity in clinical trials or focusing on what we are doing internally to celebrate and promote equality and diversity.
Throughout 2021, we have made a pledge to share our education and experiences with our clients and colleagues, to ensure inclusivity across the board. Each month we will be releasing communications in line with national and international awareness campaigns.
This month, we will be looking into International Women with Alopecia as part of our July Awareness blog.
What is Alopecia?
Alopecia areata is a condition that causes hair to fall out in small patches, which can be unnoticeable. These patches may connect, however, and then become noticeable. The condition develops when the immune system attacks the hair follicles, resulting in hair loss.
Sudden hair loss may occur on the scalp, and in some cases the eyebrows, eyelashes, and face, as well as other parts of the body. It can also develop slowly and recur after years between instances.
The condition can result in total hair loss, called alopecia universalis, and it can prevent hair from growing back. When hair does grow back, it’s possible for the hair to fall out again. The extent of hair loss and regrowth varies from person to person.
There’s currently no cure for alopecia areata. However, there are treatments that may help hair grow back more quickly and that can prevent future hair loss, as well as unique ways to cover up the hair loss. Resources are also available to help people cope with stress related to hair loss.
Alopecia areata in males
Alopecia areata occurs in both men and women, but the loss of hair is likely to be more significant in men. Men are also more likely to have a family history of the hair loss condition.
Men may experience hair loss in their facial hair, as well as their scalp, chest, and back hair. Compared to male-pattern baldness, which is a gradual thinning of hair all over, hair loss from this condition causes patchy hair loss.
Alopecia areata in females
Females are more likely to develop alopecia areata than males, but it’s not clear why. The hair loss can occur on the scalp, as well as the eyebrows and lashes.
Unlike female-pattern hair loss, which is a gradual thinning of hair that covers a large area, alopecia areata may be confined to a small area. Hair loss may occur all at once, too. The area can gradually expand, which results in greater hair loss.
Alopecia areata in children
Children can develop alopecia areata. In fact, most people with the condition will experience their first hair loss before the age of 30.
Alopecia risk factors
A close blood relative with alopecia areata: It’s estimated that about 10% to 20% of people with alopecia areata have a family member who has it. Because many people try to hide hair loss, this percentage may be higher.
Asthma, hay fever, atopic dermatitis, thyroid disease, vitiligo, or Down syndrome: Research shows that people who have one of these diseases are more likely to get alopecia areata.
Being treated for cancer with a drug called nivolumab: While it’s too early to say whether this greatly increases your risk, a few cancer patients who received a drug called nivolumab have developed alopecia areata. The drug is used to treat lung cancer and melanoma that has spread. Hair loss usually begins a few months after they start treatment. It’s called nivolumab-induced alopecia areata, and the hair loss is considered a good sign. This type of hair loss usually means that the drug is working. You can treat this hair loss with a corticosteroid that you apply to the bald spots. It allows the hair to regrow without stopping cancer treatment.
A person’s race may also affect their risk of getting alopecia areata. In a large study, researchers found that black and Hispanic nurses were more likely than non-Hispanic white nurses to develop this disease.
While this study spanned several years, it has many limitations. For example, it only looked at women nurses in the United States. More research is needed to know whether this finding holds true for other people. 
Psychological Impact in women with alopecia
Hair loss can be a traumatic experience for many females. The psychological impact in females tends to be greater than in males, because females often place more importance on their physical appearance than males do. It is also more socially acceptable and understood when hair loss occurs in males, since hair loss is more recognized in this population. In one investigational study of males and females seeking treatment for hair loss, almost twice as many females (54%) as males (28%) were very to extremely upset about their hair loss. 
One article on female alopecia states that ‘alopecia is a significant problem for many females that should not be casually disregarded. Although FDA-approved pharmacologic options for female alopecia are limited, several medications are being investigated for their use in this population. Whether or not a patient decides to utilize pharmacologic treatment, there are minimization strategies that can help reduce hair loss. Regardless of the cause or type of alopecia, hair loss can significantly damage a patient’s self-image. Therefore, it is important to address both the medical and the emotional health needs of female patients with alopecia.’ 
Innovative Trials Case Study
Innovative Trials have also successfully supported recruitment in an Alopecia Trial:
A PHASE 2B/3 RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED, DOSE-RANGING STUDY TO INVESTIGATE THE EFFICACY AND SAFETY PF-06651600 IN ADULT AND ADOLESCENT ALOPECIA AREATA (AA) SUBJECTS WITH 50% OR GREATER SCALP HAIR LOSS
Innovative Trials supported the study with site optimisation calls, website referral calls and Investigator Site Recruitment Plan calls. Impact from our Clinical Enrolment Managers (CEMs) supporting the study showed the following:
The average number of patients randomised saw a 2.2 times increase at the CEM sites (average of 29 patients randomised per month) when compared to the sites not supported by our CEMs (average of 13 patients randomised per month). CEM sites therefore randomised 123% more patients per month, than at sites which were not receiving CEM support.
 HAIR LOSS TYPES: ALOPECIA AREATA CAUSESIn-text: (Hair loss types: Alopecia areata causes, 2021) Your Bibliography: Aad.org. 2021. Hair loss types: Alopecia areata causes. [online] Available at: <https://www.aad.org/public/diseases/hair-loss/types/alopecia/causes> [Accessed 13 July 2021].
 Alopecia Areata Case Study – Innovative Trials
 RASHI C. WAGHEL, N. C. Shedding Light on Female Alopecia (Rashi C. Waghel, 2021) Rashi C. Waghel, N., 2021. Shedding Light on Female Alopecia. [online] Uspharmacist.com. Available at: <https://www.uspharmacist.com/article/shedding-light-on-female-alopecia> [Accessed 13 July 2021].
Equality, Diversity and Inclusion continues to be high on our agenda. We are working behind the scenes to push this forward. Keep your eyes peeled for more.