Recent research published in JAMA Dermatology highlighted a potential linkage between the use of oral contraceptive pills (OCP) and the protective effect of a common missense variant in the CYP1B1 gene on the risk of developing frontal fibrosing alopecia (FFA).

Researchers for the case-control study enrolled female patients with FFA from dermatology clinics across the UK. Patients were matched with unrelated female control subjects from the UK Biobank based on age and ancestry (1:66 ratio). The primary objective was to determine if OCP use modulated the effect of the CYP1B1 variant on FFA risk. The study population included 489 female FFA patients, with a mean age of 65.8 years, of whom 75.7% had a history of OCP use. In contrast, the control group consisted of 34,254 women, with a mean age of 65.0 years, and 91.0% reported previous OCP use. Researchers then used a logistic regression model with a multiplicative interaction term under an additive genetic model for the analysis.

According to the study results, there was an association between the CYP1B1 risk allele and FFA in those who had used OCPs (odds ratio [OR], 1.90; 95% CI, 1.50-2.40; P = 8.41 × 10⁻⁸), but not in those who had never used OCPs (OR, 1.16; 95% CI, 0.82-1.64; P = 0.39). A significant additive interaction was reported between the c.1358A allele and OCP use on FFA risk (OR for interaction, 1.63; 95% CI, 1.07-2.46; P = 0.02).

"This gene-environment interaction analysis suggests that the protective effect of the CYP1B1 missense variant on FFA risk might be mediated by exposure to OCPs," the authors wrote. "The allele that encodes an asparagine at position 453 of CYP1B1 was associated with increased odds of FFA only in participants with OCP history."

Source: Rayinda T, et al. JAMA Dermatology. 2024. Doi:10.1001/jamadermatol.2024.1315