Real-world evidence on treatment patterns of pediatric patients with atopic dermatitis (AD) is sparse.
To assess current treatment patterns in pediatric AD patients.
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.
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.
Identification of AD patients relied on billing diagnoses; the disease severity was proxied by the treatment prescribed.
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.Le texte complet de cet article est disponible en PDF.
Key words : adolescents, atopic dermatitis, children, eczema, infants, systemic treatment, topical calcineurin inhibitors, topical corticosteroids, topical treatment
Abbreviations used : AD, FDA, SCS, TCI, TCS
| Dr Paller and Dr Siegfried contributed equally to the data analysis, interpretation, drafting, and revising of this article.
| Funding sources: Supported by Regeneron Pharmaceuticals Inc and Sanofi.
| Conflicts of interest: Dr Paller has been a consultant for and received honorarium from Regeneron Pharmaceuticals and Sanofi and has served as an investigator for Regeneron Pharmaceuticals. Dr Siegfried has been a consultant for, received honorarium from, and served as an investigator for Regeneron Pharmaceuticals and Sanofi. Mr Vekeman and Ms Héroux are employees of StatLog Inc, which received research funding for the current study. Dr Gadkari and Dr Mina-Osorio, are employees of and stockholders in Regeneron Pharmaceuticals Inc. Dr Kaur, Dr Mallya, and Mr Miao are employees of and stockholders in Sanofi.