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. 2022 Jul;12(7):1639-1657.
doi: 10.1007/s13555-022-00754-6. Epub 2022 Jun 28.

Treatment Patterns of Atopic Dermatitis Medication in 0-10-Year-Olds: A Nationwide Prescription-Based Study

Cathrine Helene Mohn  1 , Hege S Blix  2   3 , Anja Maria Brænd  4 , Per Nafstad  4   5 , Ståle Nygard  6   7 , Jon Anders Halvorsen  4   8
Affiliations

Treatment Patterns of Atopic Dermatitis Medication in 0-10-Year-Olds: A Nationwide Prescription-Based Study

Cathrine Helene Mohn et al. Dermatol Ther (Heidelb). 2022 Jul.

Abstract

Introduction: The literature on treatment patterns for paediatric atopic dermatitis (AD) is scarce and is rarely based on real-world data. Using national registers, we sought to establish up-to-date, population-based prevalence estimates, predictors of risk and disease burden and a comprehensive overview of treatment patterns and course for paediatric patients with AD.

Methods: Dispensed prescriptions for the entire Norwegian child population aged 0-10 years from 2014 to 2020 were analysed.

Results: There were 176,458 paediatric patients with AD. Of these, 99.2% received topical corticosteroids, 5.1% received topical calcineurin inhibitors, 37.1% received potent topical corticosteroids and 2.1% received systemic corticosteroids. Of the 59,335 live births in Norway (2014), 14,385 [24.8%; 95% confidence interval (CI) 24.5-25.1] paediatric patients were treated for AD before the age of 6 years, and of these, only 934 (6.5%; 95% CI 6.1-6.9) received medication annually for 5 years or more. Compared with girls, 17.9% (95% CI 6.5-27.9) more boys were treated for at least 5 years, receiving 6.4% (95% CI 1.2-11.3) more potent topical corticosteroids and 12.4% (95% CI 6.5-18.0) more were treated for skin infections. Compared with patients with late-onset treatment, 18.9% (95% CI 7.5-29.0) more paediatric patients with early-onset treatment were still receiving treatment at 5 years of age, 15.7% (95% CI 7.1-23.4) more paediatric patients received potent topical corticosteroids and 44.4% (95% CI 36.5-51.2) more paediatric patients were treated for skin infections.

Conclusion: Most paediatric patients were treated for a mild disease for a limited period. Although the prevalence of AD is higher at a younger age, these paediatric patients were the least likely to receive potent topical corticosteroids. Male sex and early-onset AD are associated with and are potential predictors of long-term treatment and treatment of potent topical corticosteroids, antihistamines and skin infections, which may have clinical utility for personalised prognosis, healthcare planning and future AD prevention trials.

Keywords: Atopic dermatitis; Child; Dermatologic agents; Eczema; Emollients; Pharmacoepidemiology; Prescriptions; Topical calcineurin inhibitor; Topical corticosteroids.

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