Treatment patterns of pediatric patients with atopic dermatitis: A claims data analysis

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:82

Article

Paller, Amy S.^1,2  Siegfried, Elaine C.^3,4  Vekeman, Francis⁵  Gadkari, Abhijit⁶  Kaur, Mandeep⁷  Mallya, Usha G.⁷  Heroux, Julie⁵  Miao, Raymond⁸  Mina-Osorio, Paola⁶ 

[1] Northwestern Univ, Feinberg Sch Med, Dept Dermatol, Chicago, IL 60611 USA

[2] Northwestern Univ, Feinberg Sch Med, Dept Pediat, Chicago, IL 60611 USA

[3] St Louis Univ, Dept Pediat, Pediat Div Dermatol, St Louis, MO 63103 USA

[4] Cardinal Glennon Childrens Hosp, St Louis, MO USA

[5] StatLog Inc, Montreal, PQ, Canada

[6] Regeneron, Tarrytown, NY USA

[7] Sanofi, Cambridge, MA USA

[8] Sanofi, Bridgewater, NJ USA

关键词: adolescents;    atopic dermatitis;    children;    eczema;    infants;    systemic treatment;    topical calcineurin inhibitors;    topical corticosteroids;    topical treatment;   

DOI  :  10.1016/j.jaad.2019.07.105

来源: Elsevier

【 摘 要 】

Background: Real-world evidence on treatment patterns of pediatric patients with atopic dermatitis (AD) is sparse. Objective: To assess current treatment patterns in pediatric AD patients. Methods: Retrospective observational analysis of commercial insurance and Medicaid administrative claims data (January 2011-December 2016) for pediatric AD patients, stratified by age and provider type. Results: The analytic sample comprised 607,258 pediatric AD patients. Median observation period was 30.3 months. Overall, 78.6% were prescribed >= 1 AD medication; 86.7% were prescribed topical corticosteroids, and 5.4% were prescribed a calcineurin inhibitor. Systemic corticosteroids (SCSs) were prescribed for 24.4% of patients, 51.8% of whom did not have asthma or allergic comorbidities. Of the 46.6% prescribed an antihistamine and 16.2% prescribed montelukast, 62.0% and 41.3%, respectively, did not have asthma or allergic comorbidities. Systemic immunosuppressants were rarely prescribed (<0.5%). Higher potency topical corticosteroid and SCS use increased with age. Treatment patterns varied by provider type; specialists were more likely to prescribe higher potency topicals and/or systemics, regardless of patient age. A minority of patients were treated by or referred to a specialist. Limitations: Identification of AD patients relied on billing diagnoses; the disease severity was proxied by the treatment prescribed. Conclusion: Results indicate that SCSs, despite known risks, and other medications with disproven efficacy in AD are frequently prescribed, suggesting a need for safer and more effective alternatives.

【 授权许可】

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