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. 2023 Aug 30:6:e41194.
doi: 10.2196/41194.

Prescribing Patterns of Dupilumab for Atopic Dermatitis in Adults: Retrospective, Observational Cohort Study

Torunn E Sivesind  1 , Ani Oganesyan  2 , Grace Bosma  3 , Camille Hochheimer  3 , Lisa M Schilling  4   5 , Robert Dellavalle  6   7
Affiliations

Prescribing Patterns of Dupilumab for Atopic Dermatitis in Adults: Retrospective, Observational Cohort Study

Torunn E Sivesind et al. JMIR Dermatol. .

Abstract

Background: Atopic dermatitis (AD) is a common inflammatory disease caused by a type 2 T helper cell-mediated immune response to environmental antigens. Approximately 1 in 5 patients with AD presents with moderate to severe disease, and treatments approved by the Food and Drug Administration include emollients, topical glucocorticoids, and calcineurin inhibitors. Dupilumab, a fully human monoclonal antibody, improves AD via inhibition of interleukin-4 and interleukin-13.

Objective: Our aim was to characterize the prescribing patterns of dupilumab for AD in adults at a large university-affiliated health system.

Methods: A retrospective, observational cohort study was conducted using electronic data from the Observational Health Data Sciences and Informatics database, assessing data from the University of Colorado Medical Campus and its affiliates. The outcome measured was the prevalence of dupilumab prescribed for adults with AD (n=6421), between March 28, 2013, and March 28, 2021. We assessed whether the characteristics of patients who received dupilumab were different from those who did not. Each patient characteristic was assessed using a univariate logistic regression with the binary outcome of receiving or not receiving dupilumab.

Results: We found a population prevalence of 5.6% (6421/114,476) for AD. In our cohort, Black patients with AD were more than twice as likely to have received dupilumab compared to White patients (odds ratio 2.352, 95% CI 1.58-3.39). Patients with a diagnosis of atopic neurodermatitis were approximately twice as likely to have received dupilumab compared to those with other diagnostic variants of AD (odds ratio 1.87, 95% CI 1.01-3.22).

Conclusions: Our results demonstrate that both patient racial characteristics and specific AD diagnoses were associated with variations in dupilumab prescription patterns.

Keywords: Dupixent; adults; asthma; atopic dermatitis; biologics; chronic sinusitis; data; dermatitis; dermatologist; dermatology; disease; dupilumab; eczema; eosinophilic; immune; immune response; inflammatory; monoclonal antibody; nasal polyp; neurodermatitis; prescribing patterns; systemic treatment.

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Conflict of interest statement

Conflicts of Interest: RD is editor in chief of the JMIR Dermatology, an editor for Cochrane Skin, a dermatology section editor for UpToDate, a social media editor for the Journal of the American Academy of Dermatology (JAAD), and a Cochrane council cochair. TES is an editorial board member at large for JMIR Dermatology. RD receives editorial stipends (JMIR Dermatology), royalties (UpToDate), and expense reimbursement from Cochrane. TES receives fellowship funding from Pfizer, Inc. All other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of included patients. UCHEALTH: University of Colorado Health; CHCO: Children's Hospital Colorado.
See this image and copyright information in PMC

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