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Observational Study
. 2025 Dec;39(12):2096-2112.
doi: 10.1111/jdv.20876. Epub 2025 Aug 20.

Baseline characteristics of atopic eczema patients enrolled in seven European registries united in the TREatment of ATopic eczema (TREAT) registry taskforce

A H Musters  1 , L A A Gerbens  1 , L van der Gang  1   2 , M A Middelkamp-Hup  1 , W Ouwerkerk  1   3 , D J Hijnen  4 , E Haufe  5 , L Heinrich  5 , T Werfel  6 , S Weidinger  7 , J Schmitt  5 , A Svedbom  8   9 , E K Johansson  8   9 , M Bradley  8   9 , L B von Kobyletzki  10   11 , I Vittrup  12 , I F Ruge  12   13 , J P Thyssen  14 , C Vestergaard  15 , J M Carrascosa  16 , M de Vega  17 , I García-Doval  17 , A Chiricozzi  18   19 , L Stingeni  20 , P Calzavara-Pinton  21 , M R Ardern-Jones  22   23 , N J Reynolds  24   25 , C Flohr  26 , P I Spuls  1 ; A‐STAR, AtopyReg, BIOBADATOP, SCRATCH, SwedAD, TREATgermany and TREAT NL/BE registry teams
Collaborators, Affiliations
Observational Study

Baseline characteristics of atopic eczema patients enrolled in seven European registries united in the TREatment of ATopic eczema (TREAT) registry taskforce

A H Musters et al. J Eur Acad Dermatol Venereol. 2025 Dec.

Abstract

Background: The TREAT Registry Taskforce is a collaborative effort of international registries aiming to provide real-world data on the long-term efficacy, cost-effectiveness and safety of systemic treatments and phototherapy for atopic eczema (AE).

Objectives: This study seeks to present a comprehensive overview of the demographics, prior systemic treatments, clinical characteristics and disease severity and burden at baseline among patients enrolled in seven TREAT registries. Moreover, the aim is to gain insight into the differences between the registries and to explore the current prescribing practices of various therapies for patients with AE across Europe.

Methods: Data from June 2016 to 31 October 2022, were collected from seven observational cohorts: A-STAR (UK/Ireland), AtopyReg (Italy), Biobadatop (Spain), SCRATCH (Denmark), SwedAD (Sweden), TREATgermany (Germany) and TREAT NL/BE (Netherlands/Belgium).

Results: The analysis included 5337 patients, with a mean age of 39.1 years (6.3% paediatric, 54.4% male). Of these, 84.1% had previously received systemic treatments, primarily systemic corticosteroids (58.8%) and ciclosporin (39.0%), while 30.1% had undergone phototherapy. At enrolment, dupilumab was the most prescribed treatment (75.0%), followed by ciclosporin (7.8%) and Janus Kinase inhibitors (5.9%); only 1.7% started phototherapy. Baseline assessments showed that most patients had moderate (41.9%) to severe (30.1%) AE, with an average Eczema Area and Severity Index (EASI) score of 17.6. The Patient-Oriented Eczema Measure (POEM) score averaged 17.2, indicating severe disease impact. The Dermatology Life Quality Index (DLQI) score averaged 13.4, and the Numerical Rating Scale (NRS) for itch was 6.4.

Conclusions: This pooled analysis from the TREAT Registry Taskforce highlights the variability and similarities in data collection across national registries, providing significant insights into the baseline characteristics of the patient population. It establishes a robust foundation for future analyses of key effectiveness and safety outcomes.

Keywords: atopic dermatitis; atopic eczema; baseline; demographics; disease burden; disease severity; patient‐reported outcomes; phototherapy; real‐world data; registry; systemic immunomodulating treatment.

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Conflict of interest statement

L. A. A. Gerbens: one of the main investigators of the TREAT NL/BE registry. She has no further conflicts of interest. L. F. van der Gang: is a speaker for Abbvie and Sanofi. M. A. Middelkamp‐Hup: consultancies for Sanofi and Leo Pharma and one of the main investigators of the TREAT NL/BE registry. D. J. Hijnenis or has been a consultant and/or investigator for Abbvie, Almirall, Astrazeneca, Galderma, Janssen, LEO Pharma, Lilly, Novartis, Pfizer, Sanofi, UCB. C. Flohris Chief Investigator of the UK National Institute for Health Research–funded TREAT (ISRCTN15837754) and SOFTER (ClinicalTrials.gov: NCT03270566) trials and the UK‐Irish Atopic Eczema Systemic Therapy Register (A‐STAR; ISRCTN11210918) and is a principal investigator in the European Union Horizon 2020–funded BIOMAP Consortium (http://www.biomap‐imi.eu/). He is also Chief Investigator of the EU Joint Program Initiative TRANS‐FOODS consortium. His department has also received investigator‐led funding from Sanofi Genzyme for skin microbiome work. A. Chiricozzi: advisory board member and consultant and has received fees and speaker's honoraria or has participated in clinical trials for AbbVie, Almirall, Bristol Myers Squibb, Leo Pharma, Lilly, Janssen, Novartis, Pfizer and Sanofi Genzyme. L. Stingeni has been principal investigator in clinical trials sponsored by and/or received personal fees from AbbVie, Almirall, Celgene, Eli Lilly, Janssen, Leo Pharma, Novartis and Sanofi Genzyme. P. Calzavara‐Pinton has been a consultant for Sanofi, AbbVie, Leo, Cantabria, Pierre Fabre, Galderma, Janssen and Novartis. E. K. Johansson: received speaker honoraria and/or has been a consultant for AbbVie, ACO, Galenica, LEO Pharma, Novartis, Sanofi Genzyme and the Swedish Asthma and Allergy Association. A. Svedbom: received speaker honoraria and/or has been a consultant for AbbVie, BMS, Eli Lilly, ICON, Janssen, Novartis, BMS and UCB. M. Bradley has been principal investigator in clinical trials sponsored by and/or received speaker honoraria and/or been a consultant for Abbvie, ACO, Amgen, LEO Pharma, Pfizer, Novartis and Sanofi Genzyme. L. B. Kobyletzki: Has acted as a collaborative researcher/consultant/speaker for Pfizer, Sanofi, Leo Pharma and Eli Lilly. E. Haufe: coordinator of TREATgermany; no further conflicts of interest. L. Heinrich: research associate of TREATgermany; no further conflicts of interest. J. Schmitt: PI of TREATgermany; institutional funding of IITs from Sanofi, Novartis, Pfizer, ALK; consultancies for Sanofi, Lilly, Novartis, ALK. J. M. Carrascosa served as a consultant and participated in speakers' bureaus for Abbott Laboratories, Janssen Pharmaceuticals Inc., MSD and Pfizer‐Wyeth. I. García‐Doval: received financial compensation for talks unrelated to atopic dermatitis from UCB and Novartis, and a travel grant from Janssen. N. J. Reynolds has received, through Newcastle University, research grant funding, funding for lectures and/or travel support from Celgene, Genentech and Sanofi Genzyme. He is a principal investigator on the UK‐Irish Atopic Eczema Systemic Therapy Register (A‐STAR; ISRCTN11210918). M. R. Ardern‐Jones: Has acted as a collaborative researcher/consultant/speaker for AbbVie, Almirall, Amgen, Galderma, Janssen, Leo Pharma, Lilly, Novartis, Pfizer, Regeneron, Sanofi Genzyme, UCB, Unilever. I. Vittrup has received financial research support from Sanofi/Regeneron Pharmaceuticals, Pfizer, Eli Lilly and Abbvie and personal honoraria for lecturing from Pfizer and Abbvie and has been a sub‐investigator for Leo Pharma. J. Thyssen: advisor, speaker or investigator for Abbvie, Arena, Pfizer, LEO Pharma, Regeneron, Sanofi Genzyme, Almirall and Eli Lilly. He has received research grants from Regeneron and Sanofi Genzyme. He is an employee of LEO Pharma. C. Vestergaard: speaker/honorarium for Sanofi, Leo Pharma, Abbvie, Pfizer, Pierre Fabre, Astra Zeneca, Almirall, Novartis. P. I. Spuls has done consultancies in the past for Sanofi 111017 and AbbVie 041217 (unpaid), receives departmental independent research grants from pharmaceutical industries since December 2019 for the TREAT NL/BE registry, is involved in performing clinical trials with many pharmaceutical industries that manufacture drugs used for the treatment of, for example, psoriasis and atopic dermatitis, for which financial compensation is paid to the department/hospital and is Chief Investigator (CI) of the systemic and phototherapy atopic eczema registry (TREAT NL/BE) for adults and children and one of the main investigators of the SECURE‐AD registry. No other disclosures were reported.

Figures

FIGURE 1
FIGURE 1
Past systemic treatment for atopic eczema (AE). In total, 3775 patients had previous systemic treatment, with potential for 0 or >1 treatment per patient. *Any systemic treatment besides systemic corticosteroids. SwedAD registry does not collect data on past systemic treatment.
FIGURE 2
FIGURE 2
Percentage of patients treated with various systemic treatments or phototherapy before enrolment in the registries. Each bar represents a registry (100%), with segments showing the proportion of patients exposed to each treatment. Total number of treatments = 4591. MMF/MPA, mycophenolate mofetil or mycophenolic acid. *Any systemic treatment besides systemic corticosteroids. SwedAD (SE) does not collect data on past systemic treatment. SwedAD (SE) and SCRATCH (DK) do not collect data on past treatment with phototherapy.
FIGURE 3
FIGURE 3
Systemic treatment started at enrolment into the registries. In total, 3952 patients started a specific systemic treatment, with potential for 0 or >1 treatment per patient. MMF/MPA, mycophenolate mofetil or mycophenolic acid. *Any systemic treatment besides systemic corticosteroids. SCRATCH (DK) does not include patients on conventional systemic treatments.
FIGURE 4
FIGURE 4
Systemic treatment or phototherapy started at enrolment into each registry. Total number of treatments = 3960. MMF/MPA, mycophenolate mofetil or mycophenolic acid. *Any systemic treatment besides systemic corticosteroids. SCRATCH (DK) does not include patients initiating conventional systemic treatments. Biobadatop (ES), SCRATCH (DK) and SwedAD (SE) do not include patients initiating phototherapy.
FIGURE 5
FIGURE 5
Disease severity at baseline across all registries, measured with Validated Investigator Global Assessment scale for Atopic Dermatitis (vIGA‐AD), Patient‐Oriented Eczema Measure (POEM) and Eczema Area and Severity Index (EASI) score. Biobadatop (Spain), SCRATCH (Denmark) and SwedAD (Sweden) do not collect vIGA‐AD.
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