Real-world treatment patterns for atopic dermatitis in South Korea

Abstract

The phenotypes of atopic dermatitis (AD) are diverse, and ethnic differences have been suggested. To date, few studies have explored large-scale national data on the treatment patterns of AD in Asians. Therefore, we aimed to examine real-world treatment patterns for AD, including the probability of discontinuation of AD treatment and restart after discontinuation. A retrospective observational study was conducted using the nationwide healthcare database in South Korea between January 1, 2016 to July 31, 2020. We identified 944,559 pediatric patients and 1,066,453 adults with AD. Topical corticosteroids and antihistamines were the most commonly prescribed medications in all age groups. The frequency of topical corticosteroid prescription decreased as the age increased. Although immunosuppressive drugs were not widely used in both children and adults, cyclosporine was the most frequently prescribed immunosuppressant, particularly among those aged 12 years or more (1–2%). Pediatric patients were more likely to discontinue treatment than adult patients. Treatment restart for moderate-to-severe AD was earlier than that for overall AD. In conclusion, significant differences were observed in the treatment patterns of AD between pediatric and adult patients. These findings will improve our understanding of the latest treatment patterns for AD, which may contribute to decision-making in clinical practice.

Burden of Disease and Unmet Needs in the Diagnosis and Management of Atopic Dermatitis in Korea

“…AD diagnosis can be made in Korea when at least 2 of the 4 major features and 4 of 14 minor features are fulfilled. These criteria have been widely used in clinical practice and studies conducted on Korean AD patients [53][54][55]. Recently, the simplified 2-plus-1 AD diagnostic criteria, which comprise two essential features and one important feature, is also recommended by the American Academy of Dermatology (AAD) [56].…”

Long-Term Use of Oral Corticosteroids and Safety Outcomes for Patients With Atopic Dermatitis

“…4 The prevalence of AD among adults ranged from 2.1% to 4.9% across countries, and up to 10% of adults required medication for moderate to severe AD due to inadequate response to topical therapies; the prevalence rates were higher among adult patients than among pediatric patients, of whom 1.5% required medication for moderate to severe AD. [5][6][7] As AD treatment strategies, international guidelines and expert opinions generally recommend that oral corticosteroids should generally be avoided or limited to the short term only as rescue therapy. [8][9][10][11] Nonetheless, given the benefits of oral corticosteroids, including their effectiveness in allergic diseases, short-term safety, and low cost, many patients with moderate to severe AD are treated with oral corticosteroids for prolonged periods, which may constitute inappropriate or excessive use.…”

Challenges and Future Trends in Atopic Dermatitis

“…Atopic dermatitis (AD) is a common chronic inflammatory skin disorder affecting approximately 11 to 20% of children and 5-8% adults. In a retrospective observational study conducted in South Korea by Lee et al,944,559 pediatric patients and 1,066,453 adults with AD were identified [1,2]. This condition, described as a heterogenous inflammatory skin disease, consists of various subtypes based on clinical (disease stage/chronicity), demographics (age, ethnicity), and molecular parameters/endotypes.…”