Are Systemic Therapies Underutilized for Moderate to Severe Atopic Dermatitis?

Atopic dermatitis (AD) is frequently managed with the conservative use of topical therapies, despite consensus-based guidelines suggesting that systemic agents may also be useful for managing various dimensions of AD, according to research results published in the Journal of the European Academy of Dermatology and Venereology.

The study examined retrospective data from a database comprising adult patients with either chronic AD (n=401), psoriasis (n=535), or chronic urticaria (n=230). The researchers analyzed and compared patient data with regard to epidemiology, disease severity, and therapeutic agents or interventions used to manage their disease. Prescribing practices were also compared in patients with AD, psoriasis, and chronic urticaria.

Overall, the percentage of patients who presented with moderate to severe disease was 72.8% for AD, 39% for chronic urticaria, and 16.9% for psoriasis. These findings suggested that control of AD may not be as optimal as control for chronic urticaria or psoriasis. Only 8% of patients with moderate to severe AD received systemic therapy, despite being eligible for this approach.

In comparison, 46.5% of patients with psoriasis and 26% of patients with chronic urticaria received a systemic agent. The majority of patients with AD (78.2%) completed a therapeutic educational program, whereas only approximately 35% of patients with chronic urticaria and 3% of patients with psoriasis completed such a program.

Although the 3 diseases analyzed in this study share common features, the differences in how they are managed suggest therapeutic guidelines for each disease should be homogenized in an effort to standardize clinical care.

The researchers also added that they hope their findings encourage “introducing a systemic treatment more proactively for moderate-to-severe AD patients to conform to the guidelines and the therapeutic algorithms established in psoriasis and chronic urticaria.”

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Disclosure: This clinical trial was supported by Novartis. Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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Pascal C, Maucort-Boulch D, Gilibert S, et al. Therapeutic management of adults with atopic dermatitis: comparison with psoriasis and chronic urticaria [published online March 2, 2020]. J Eur Acad Dermatol Venereol. doi:10.1111/jdv.16329