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
. 2022 Sep;39(9):4157-4168.
doi: 10.1007/s12325-022-02197-z. Epub 2022 Jul 12.

Real-World Effectiveness of Newly Initiated Systemic Therapy for Atopic Dermatitis in the United States: A Claims Database Analysis

Jashin J Wu  1 , Marie-Hélène Lafeuille  2 , Bruno Emond  2 , Iman Fakih  2 , Mei Sheng Duh  3 , Joseph C Cappelleri  4 , Natalie Yin  5 , Claire Feeney  6 , Daniela E Myers  7 , Marco DiBonaventura  8
Affiliations

Real-World Effectiveness of Newly Initiated Systemic Therapy for Atopic Dermatitis in the United States: A Claims Database Analysis

Jashin J Wu et al. Adv Ther. 2022 Sep.

Abstract

Introduction: Atopic dermatitis (AD) is associated with significant quality-of-life and economic burdens. Real-world evidence is needed to identify optimal treatment pathways for AD. Here we evaluate real-world effectiveness of systemic therapies for moderate-to-severe AD in the USA.

Methods: Data (September 2016 to December 2019) were from the IQVIA Health Plan Claims data set (IQVIA, Danbury, CT) from patients aged 12 years or older with AD (ICD-9/10-CM, 691.8/L20.x) initiating a systemic immunosuppressive (SIS) agent (methotrexate, cyclosporine, mycophenolate, or azathioprine) or dupilumab and continuously enrolled for at least 6 months before and after the index date. Indicators of non-response (i.e., adding on/switching systemic therapy, AD-related inpatient/emergency room visits, or incident staphylococcal/streptococcal skin infection) and predictors of non-response were evaluated. Descriptive statistics and Kaplan-Meier rates and times were obtained; Cox regression models were used.

Results: In 3249 patients, 45.4% exhibited at least one indicator of non-response, with median time to non-response being longer for dupilumab than for any SIS therapy (27.0 vs 4.0-7.7 months, respectively). Key non-response predictors were age, geographic region, and baseline number of annual AD-related medical visits.

Conclusion: Non-response was common in patients with AD who required systemic treatment, and non-response indicators occurred significantly more frequently with SIS treatment than with dupilumab treatment.

Keywords: Atopic dermatitis; Dupilumab; Non-response; Real-world study; Systemic immunosuppressive agents.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Study design. AD atopic dermatitis
Fig. 2
Fig. 2
Non-response outcomes for patients new to systemic treatments for AD. AD atopic dermatitis, GAS group A streptococci
Fig. 3
Fig. 3
Kaplan–Meier curve of indicators of non-response to index treatment
Fig. 4
Fig. 4
Forest plot of hazard ratios (95% CI) for predictors of indicators of non-response to index treatment (overall population and dupilumab subgroup). AD atopic dermatitis, CI confidence interval, ER emergency room, HMO health maintenance organization, I/T/CDHC/HAS/U Indemnity/Traditional/Consumer Directed Healthcare/Health Savings Account/Unknown, POS point of service, PPO preferred provider organization, SCS systemic corticosteroid, SIS systemic immunosuppressant. *p < 0.05, **p < 0.001
See this image and copyright information in PMC

References

    1. Weidinger S, Beck LA, Bieber T, Kabashima K, Irvine AD. Atopic dermatitis. Nat Rev Dis Primers. 2018;4(1):1. doi: 10.1038/s41572-018-0001-z. - DOI - PubMed
    1. Eckert L, Gupta S, Amand C, Gadkari A, Mahajan P, Gelfand JM. The burden of atopic dermatitis in US adults: health care resource utilization data from the 2013 National Health and Wellness Survey. J Am Acad Dermatol. 2018;78(1):54–61.e1. doi: 10.1016/j.jaad.2017.08.002. - DOI - PubMed
    1. Silverberg JI, Gelfand JM, Margolis DJ, et al. Patient burden and quality of life in atopic dermatitis in US adults: a population-based cross-sectional study. Ann Allergy Asthma Immunol. 2018;121(3):340–347. doi: 10.1016/j.anai.2018.07.006. - DOI - PubMed
    1. Kwatra SG, Gruben D, Fung S, DiBonaventura M. Psychosocial comorbidities and health status among adults with moderate-to-severe atopic dermatitis: a 2017 US national health and wellness survey analysis. Adv Ther. 2021;38(3):1627–1637. doi: 10.1007/s12325-021-01630-z. - DOI - PMC - PubMed
    1. Bylund S, von Kobyletzki LB, Svalstedt M, Svensson A. Prevalence and incidence of atopic dermatitis: a systematic review. Acta Derm Venereol. 2020;100(12):adv00160. doi: 10.2340/00015555-3510. - DOI - PMC - PubMed

Substances

LinkOut - more resources