Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec;183(6):1073-1082.
doi: 10.1111/bjd.18959. Epub 2020 Mar 18.

The European TREatment of ATopic eczema (TREAT) Registry Taskforce survey: prescribing practices in Europe for phototherapy and systemic therapy in adult patients with moderate-to-severe atopic eczema

F M Vermeulen  1 , L A A Gerbens  1 , J Schmitt  2   3 , M Deleuran  4 , A D Irvine  5   6   7 , K Logan  8 , W Ouwerkerk  9   10 , C Vestergaard  4 , C Flohr  10 , P I Spuls  1 ; international TREAT Registry Taskforce
Affiliations

The European TREatment of ATopic eczema (TREAT) Registry Taskforce survey: prescribing practices in Europe for phototherapy and systemic therapy in adult patients with moderate-to-severe atopic eczema

F M Vermeulen et al. Br J Dermatol. 2020 Dec.

Abstract

Background: For many years dermatologists have had access to few therapies for patients with moderate-to-severe atopic eczema (AE). New promising therapies are entering the market but conventional phototherapies and systemic therapies have more well-known safety profiles, lower costs and wider availability.

Objectives: To provide insight into current prescribing practices of conventional phototherapy and systemic immunomodulatory therapies for adults with chronic AE, and the factors influencing these prescribing practices, before biologics and other novel therapeutics become routine clinical practice.

Methods: In this exploratory study dermatologists were invited to participate in an online survey via a mailing list of the European Academy of Dermatology and Venereology and national societies. Data were collected on participant characteristics (including clinical practice data), the use of phototherapies and systemic therapies, and factors influencing their use.

Results: From 30 European countries, 238 out of 361 dermatologists willing to participate (65·9%) completed the survey, with 229 meeting the inclusion criteria. For phototherapy (prescribed by 84·7%), most preferred narrowband ultraviolet B as first line (80·9%) and psoralen plus ultraviolet A as second (21·6%). For systemic therapy (prescribed by 95·2%) ciclosporin (54·1%), oral corticosteroids (32·6%) and methotrexate (30·7%) were used first line. Dermatologists relied mostly on personal experience for prescribing phototherapy and systemic therapy. Azathioprine and mycophenolic acid were prescribed by only 135 (59·0%) and 85 (37·1%) participants in total, mostly due to a lack of personal experience.

Conclusions: This study provides insight into prescribing practices for conventional phototherapy and systemic therapy in Europe and shows that off-label therapies are also preferred as first-line choice of systemic therapy.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Number of participants per country.
Figure 2
Figure 2
(a) Percentages of participants who had access to photo(chemo)therapy (in general) per country. (b) Percentages of participants who had access to systemic therapy (in general) per country. (c) Percentages of participants who had access to dupilumab per country. The countries with more than 10 participants are Denmark, France, Germany, Ireland, Italy, Portugal, Spain and the Netherlands.
Figure 3
Figure 3
First‐, second‐ and third‐line choice of (a) phototherapy (n = 194) and (b) systemic therapy (n = 218). Participants were able to select multiple therapies as first line, second line, third line, rarely or never prescribed.
See this image and copyright information in PMC

Comment in

References

    1. Roekevisch E, Spuls PI, Kuester D et al Efficacy and safety of systemic treatments for moderate‐to‐severe atopic dermatitis: a systematic review. J Allergy Clin Immunol 2014; 133:429–38. - PubMed
    1. Garritsen FM, Brouwer MW, Limpens J et al Photo(chemo)therapy in the management of atopic dermatitis: an updated systematic review with implications for practice and research. Br J Dermatol 2014; 170:501–13. - PubMed
    1. Roekevisch E, Schram ME, Leeflang MMG et al Methotrexate versus azathioprine in patients with atopic dermatitis: 2‐year follow‐up data. J Allergy Clin Immunol 2018; 141:825–7. - PubMed
    1. Gerbens LAA, Hamann SAS, Brouwer MWD et al Methotrexate and azathioprine for severe atopic dermatitis: a 5‐year follow‐up study of a randomized controlled trial. Br J Dermatol 2018; 178:1288–96. - PubMed
    1. Nankervis H, Thomas KS, Delamere FM et al What is the evidence base for atopic eczema treatments? A summary of published randomized controlled trials. Br J Dermatol 2017; 176:910–27. - PubMed

Publication types