Pascal C, Maucort-Boulch D, Gilibert S, Bottigioli D, Verdu V, Jaulent C, Hacard F, Bérard F, Nicolas J-F, Nosbaum A
Université Claude Bernard Lyon 1, Lyon Cedex 03, France.
Department of Biostatics and Bioinformatic, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France.
J Eur Acad Dermatol Venereol. 2020 Oct;34(10):2339-2345. doi: 10.1111/jdv.16329. Epub 2020 Apr 27.
The therapeutic options in atopic dermatitis rely on consensus-based guidelines, also established for psoriasis and chronic urticaria. However, the therapeutic approach in atopic dermatitis, especially in the moderate-to-severe forms of the disease, seems less aggressive than in psoriasis and in chronic urticaria with a less frequent use of systemic agents.
To compare in real-life conditions the therapeutic management of adults with atopic dermatitis with those with psoriasis and chronic urticaria.
A transversal analysis was performed in May 2017, using retrospective data from a monocentric database. Data on epidemiology, severity, therapeutic educational intervention and systemic treatments were analysed from 401 patients with atopic dermatitis, compared with data from 230 patients with chronic urticaria and 535 patients with psoriasis.
A high proportion (73%) of atopic dermatitis patients presented with a moderate-to-severe form of the disease compared to only 39% of chronic urticaria and 17% of psoriasis patients. Most of atopic dermatitis patients (78%) had completed a therapeutic educational programme, while the adherence was lower in chronic urticaria (35%) and in psoriasis (3%) patients. A systemic treatment, including biologicals, was recorded in 8% of atopic dermatitis patients, while it concerned 26% and 47% of chronic urticaria and psoriasis patients, respectively.
We confirmed that atopic dermatitis treatment mostly relies on topical treatments. Only a minority of moderate-to-severe atopic dermatitis patients who are eligible for a systemic treatment receive such therapy. This may suggest promoting a more frequent use of systemic agents in moderate-to-severe atopic dermatitis.
特应性皮炎的治疗选择依赖于基于共识的指南，这些指南也适用于银屑病和慢性荨麻疹。然而，特应性皮炎的治疗方法，尤其是中重度形式的疾病，似乎比银屑病和慢性荨麻疹的治疗方法更保守，全身用药的频率较低。
在实际情况下比较成人特应性皮炎与银屑病和慢性荨麻疹的治疗管理。
2017年5月进行了一项横断面分析，使用来自单中心数据库的回顾性数据。分析了401例特应性皮炎患者的流行病学、严重程度、治疗教育干预和全身治疗数据，并与230例慢性荨麻疹患者和535例银屑病患者的数据进行比较。
与仅39%的慢性荨麻疹患者和17%的银屑病患者相比，高比例（73%）的特应性皮炎患者表现为中重度疾病。大多数特应性皮炎患者（78%）完成了治疗教育计划，而慢性荨麻疹患者（35%）和银屑病患者（3%）的依从性较低。8%的特应性皮炎患者接受了包括生物制剂在内的全身治疗，而慢性荨麻疹患者和银屑病患者的这一比例分别为26%和47%。
我们证实特应性皮炎的治疗主要依赖于局部治疗。只有少数符合全身治疗条件的中重度特应性皮炎患者接受了此类治疗。这可能表明应促进在中重度特应性皮炎中更频繁地使用全身药物。
