Treatment of adult atopic dermatitis patients according to disease characteristics and demographics

Abstract

Little is currently known about possible associations between disease specific characteristics of atopic dermatitis (AD) and use of medical treatments. We explored the use of AD treatments within the past 12 months in Danish adults according to distinct patient characteristics. Patients who had received a diagnosis of AD in a hospital in-or outpatient setting as adults were surveyed and data cross-linked to a national prescription registry. AD severity was measured by the Patient-Oriented SCORing Atopic Dermatitis (PO-SCORAD). A total of 3834 patients participated. Use of topical medication in the past 12 months increased with increasing AD severity, whereas no difference was observed for systemic medication use. Positive associations between AD in the face and neck, and use of mild and moderately potent topical corticosteroids were observed, while involvement of palms and chest was associated with use of more potent topical corticosteroids. The mean DLQI, skin pain, and itch severity scores were lower in patients managed only with topical corticosteroids (5.5, 3.2, and 4.3, respectively) compared to patients treated with both oral and topical medication (7.1, 3.8, and 5.0, respectively). Patients with frequent topical corticosteroid use tended to be older (50.7 vs 48.6 years), males (50.0% vs 33.6%), current daily smokers (17.3% vs 13.7%), and having asthma (59.1% vs 43.8%) compared with infrequent users of topical corticosteroids. We found a disconnect between the severity of AD signs and symptoms, and use of AD therapies. In particular, a very modest use of systemic immunosuppressants was seen even among patients with severe AD symptoms. However, the underlying clinical decisions and reasons behind this disconnect is not clear based on the current data.

Inadequate Disease Control, Treatment Dissatisfaction, and Quality-of-Life Impairments Among US Patients Receiving Topical Therapy for Atopic Dermatitis

“…This study showed that patients with uncontrolled AD receiving topical therapy had worse QoL, symptom burden, and work impairments versus those with controlled AD, expanding upon previous AD DSP analyses that showed similar findings in patients with moderate to severe disease [19,20]. The lower DLQI scores among patients receiving topical therapy alone compared with topical plus systemic therapy observed in this study have also been previously described in a Danish registry study of patients receiving topical corticosteroids alone versus combined oral and topical treatment [29]. Findings from the present study further highlight the unmet need for well-tolerated topical AD therapies that offer disease control.…”

Baseline Body Surface Area and Itch Severity Define Response to Baricitinib in Patients with Moderate-to-Severe Atopic Dermatitis at Week 16

“…While the prevalence of the identified subgroup of patients remains to be elucidated in a real-world setting, a significant proportion of patients who are candidates for systemic therapy in clinical practice might fall within this identified group of patients with AD. Indeed, data from real-world clinical practice suggest that patients with moderate-to-severe AD have generally lower BSA involvement as compared to patients enrolled in clinical trials and an affected mean BSA more in line with patients in the BSA 10–40% than in the BSA > 40% subgroup of the current analysis [ 13 , 14 ].…”

Hospital Utilization and Medication Prescriptions among Patients with Atopic Dermatitis in South Korea: A Real-World Data Analysis

“…Previous studies in other countries also reported a high prevalence of SCS use among patients with AD; however, SCS use in Korea seems to be higher than that in other countries, especially in adults. In Denmark and Japan, approximately 12% and 30% of adults with AD received SCSs, respectively, whereas approximately 60% in Korea do 9 10 .…”