Gorritz Magdaliz, Boytsov Natalie N, Goldblum Orin M, Malatestinic William N, Wang Xin, Wade Rolin L
Real-World Evidence, Health Economics and Outcomes Research, IQVIA Inc, Plymouth Meeting, USA.
US Medical Division - Autoimmune, Eli Lilly and Company, Indianapolis, USA.
J Dermatolog Treat. 2022 Aug;33(5):2510-2517. doi: 10.1080/09546634.2021.1981813. Epub 2021 Oct 6.
Treatment for atopic dermatitis (AD) is complex, particularly in patients with inadequate response to topical therapies. Currently, there is little clinical guidance for the treatment of these patients.
A real-world retrospective study utilizing electronic medical records (EMR) and administrative claims data selected patients with AD between January 01 2016 and June 30 2018. Patients had a written prescription for a topical therapy (first observed script = index date) and no prior systemic treatment. Disease severity at index, follow-up treatment response and prescriptions patterns were assessed. A subset of patients linked to claims was evaluated for treatment patterns.
We identified 137,214 adult topical-treated AD patients with no prior systemic therapy. Among the 16,035 patients with available Physician Global Assessment (PGA) at index, 8169 (50.9%) had the moderate-to-severe disease. Among these patients, 60% had an inadequate response to topical therapy. Of 4475 patients linked to claims, 13.0% had claims for systemic therapy during follow-up, most initiated systemic steroids (95.2%), and oral immunosuppressants and biologics were initiated in 3.3% and 3.8%, respectively.
In this real-world study, inadequate response to topical therapy among moderate-to-severe AD patients was high and initiation of systemic treatment was low which suggests a need for additional AD-indicated systemic treatment options in this patient population.
特应性皮炎(AD)的治疗较为复杂,尤其是对局部治疗反应欠佳的患者。目前,针对这些患者的治疗几乎没有临床指导。
一项利用电子病历(EMR)和管理索赔数据的真实世界回顾性研究,选取了2016年1月1日至2018年6月30日期间的AD患者。患者有局部治疗的书面处方(首次观察到的处方=索引日期)且无既往全身治疗史。评估索引时的疾病严重程度、后续治疗反应和处方模式。对与索赔相关的一部分患者的治疗模式进行了评估。
我们确定了137,214例未接受过全身治疗的接受局部治疗的成年AD患者。在索引时可获得医师整体评估(PGA)的16,035例患者中,8169例(50.9%)患有中度至重度疾病。在这些患者中,60%对局部治疗反应欠佳。在4475例与索赔相关的患者中,13.0%在随访期间有全身治疗的索赔,大多数开始使用全身类固醇(95.2%),口服免疫抑制剂和生物制剂的起始使用率分别为3.3%和3.8%。
在这项真实世界研究中,中度至重度AD患者对局部治疗反应欠佳的比例较高,而全身治疗的起始率较低,这表明该患者群体需要更多有AD适应证的全身治疗选择。