Pona Adrian, Cline Abigail, Kolli Sree, Feldman Steven F., Fleischer Alan F. Jr
J Drugs Dermatol. 2019 Oct 1;18(10):987-990.
Introduction: Introduction: Although future atopic dermatitis (AD) clinical research is intended to improve standard-of-care treatment, how patients are currently treated is not well characterized. The purpose of this study was to determine the most frequent medications prescribed in all ages of AD. Methods: The National Ambulatory Medical Care Survey (NAMCS) is a nationally representative survey of United States office-based ambulatory visits and records demographics, diagnoses, and treatments. This is a cross-sectional study using the NAMCS of all AD outpatient office visits from 2006 to 2015. Patient visits with an ICD-9-CM code for AD (691.8) were collected and analyzed. Frequency tables were created for age, race, providers managing AD, and treatment. Results: Patient demographics of AD visits included 51% male (95% Confidence Interval [CI]: 44-58%), 71% white (65-77%), 19% African American (14-25%), and 10% Asian (6-14%). About 31% (24-37%) of visits were to pediatricians and 27% (22-33%) to dermatologists whereas per physician, dermatologists managed more AD visits than pediatricians. Topical corticosteroids (59%; 52-66%) were the most common class of medications prescribed followed by antibiotics (11%; 6-16%) and second generation antihistamines (6%; 3-10%). The most common topical corticosteroid prescribed in AD was triamcinolone (25% of office visits; 18-31%). Hydrocortisone was the most common topical corticosteroid prescribed to children <1 year of age and children aged 8 to 18, whereas triamcinolone was more common in children 2 to 7 years and adults >18 years. Discussion: Topical corticosteroids were the most frequent prescriptions provided at office-based ambulatory visits whereas antibiotics and second-generation antihistamines were the second and third most common prescribed medications, respectively. Although pediatricians manage more AD visits than dermatologists in total visits, dermatologists manage more AD visits than pediatricians per physician. Characterizing how AD patients are currently treated may build a reference for future clinical research investigating novel standard-of-care treatment in AD. J Drugs Dermatol. 2019;18(10):987-990.
尽管未来特应性皮炎（AD）的临床研究旨在改善标准治疗方案，但目前患者的治疗方式尚未得到充分描述。本研究的目的是确定各年龄段AD患者最常使用的药物。方法：国家门诊医疗调查（NAMCS）是一项对美国门诊就诊情况具有全国代表性的调查，记录人口统计学信息、诊断和治疗情况。这是一项横断面研究，使用了2006年至2015年所有AD门诊就诊的NAMCS数据。收集并分析了具有AD的ICD-9-CM编码（691.8）的患者就诊情况。创建了关于年龄、种族、治疗AD的医生以及治疗方法的频率表。结果：AD就诊患者的人口统计学特征包括51%为男性（95%置信区间[CI]：44-58%），71%为白人（65-77%），19%为非裔美国人（14-25%），10%为亚洲人（6-14%）。约31%（24-37%）的就诊是看儿科医生，27%（22-33%）是看皮肤科医生，然而就每位医生而言，皮肤科医生管理的AD就诊患者比儿科医生更多。外用皮质类固醇（59%；52-66%）是最常开具的药物类别，其次是抗生素（11%；6-16%）和第二代抗组胺药（6%；3-10%）。AD中最常开具的外用皮质类固醇是曲安奈德（占门诊就诊的25%；18-31%）。氢化可的松是1岁以下儿童和8至18岁儿童最常开具的外用皮质类固醇，而曲安奈德在2至7岁儿童和18岁以上成人中更常见。讨论：外用皮质类固醇是门诊就诊时最常开具的处方，而抗生素和第二代抗组胺药分别是第二和第三最常开具的药物。尽管在总就诊次数上儿科医生管理的AD就诊患者比皮肤科医生多，但就每位医生而言，皮肤科医生管理的AD就诊患者比儿科医生多。描述AD患者目前的治疗方式可能为未来研究AD新型标准治疗方案的临床研究建立参考。《药物皮肤病学杂志》。2019；18（10）：987-990。
