0至10岁儿童特应性皮炎药物治疗模式：一项基于全国处方的研究。
Treatment Patterns of Atopic Dermatitis Medication in 0-10-Year-Olds: A Nationwide Prescription-Based Study.
作者信息
Mohn Cathrine Helene, Blix Hege S, Brænd Anja Maria, Nafstad Per, Nygard Ståle, Halvorsen Jon Anders
机构信息
Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
Department of Drug Statistics, Norwegian Institute of Public Health, Oslo, Norway.
出版信息
Dermatol Ther (Heidelb). 2022 Jul;12(7):1639-1657. doi: 10.1007/s13555-022-00754-6. Epub 2022 Jun 28.
INTRODUCTION
The literature on treatment patterns for paediatric atopic dermatitis (AD) is scarce and is rarely based on real-world data. Using national registers, we sought to establish up-to-date, population-based prevalence estimates, predictors of risk and disease burden and a comprehensive overview of treatment patterns and course for paediatric patients with AD.
METHODS
Dispensed prescriptions for the entire Norwegian child population aged 0-10 years from 2014 to 2020 were analysed.
RESULTS
There were 176,458 paediatric patients with AD. Of these, 99.2% received topical corticosteroids, 5.1% received topical calcineurin inhibitors, 37.1% received potent topical corticosteroids and 2.1% received systemic corticosteroids. Of the 59,335 live births in Norway (2014), 14,385 [24.8%; 95% confidence interval (CI) 24.5-25.1] paediatric patients were treated for AD before the age of 6 years, and of these, only 934 (6.5%; 95% CI 6.1-6.9) received medication annually for 5 years or more. Compared with girls, 17.9% (95% CI 6.5-27.9) more boys were treated for at least 5 years, receiving 6.4% (95% CI 1.2-11.3) more potent topical corticosteroids and 12.4% (95% CI 6.5-18.0) more were treated for skin infections. Compared with patients with late-onset treatment, 18.9% (95% CI 7.5-29.0) more paediatric patients with early-onset treatment were still receiving treatment at 5 years of age, 15.7% (95% CI 7.1-23.4) more paediatric patients received potent topical corticosteroids and 44.4% (95% CI 36.5-51.2) more paediatric patients were treated for skin infections.
CONCLUSION
Most paediatric patients were treated for a mild disease for a limited period. Although the prevalence of AD is higher at a younger age, these paediatric patients were the least likely to receive potent topical corticosteroids. Male sex and early-onset AD are associated with and are potential predictors of long-term treatment and treatment of potent topical corticosteroids, antihistamines and skin infections, which may have clinical utility for personalised prognosis, healthcare planning and future AD prevention trials.
引言
关于儿童特应性皮炎（AD）治疗模式的文献稀缺，且很少基于真实世界数据。我们利用国家登记系统，试图建立最新的、基于人群的患病率估计、风险预测因素和疾病负担，并全面概述AD儿科患者的治疗模式和病程。
方法
分析了2014年至2020年挪威0至10岁儿童的全部配药处方。
结果
共有176458名儿科AD患者。其中，99.2%接受了外用糖皮质激素治疗，5.1%接受了外用钙调神经磷酸酶抑制剂治疗，37.1%接受了强效外用糖皮质激素治疗，2.1%接受了全身性糖皮质激素治疗。在挪威2014年出生的59335名活产婴儿中，14385名[24.8%；95%置信区间（CI）24.5 - 25.1]儿科患者在6岁前接受了AD治疗，其中只有934名（6.5%；95%CI 6.1 - 6.9）患者连续5年或更长时间每年接受药物治疗。与女孩相比，接受至少5年治疗的男孩多17.9%（95%CI 6.5 - 27.9），接受强效外用糖皮质激素治疗的男孩多6.4%（95%CI 1.2 - 11.3），接受皮肤感染治疗的男孩多12.4%（95%CI 6.5 - 18.0）。与发病较晚才开始治疗的患者相比，发病较早开始治疗的儿科患者在5岁时仍在接受治疗的多18.9%（95%CI 7.5 - 29.0），接受强效外用糖皮质激素治疗的多15.7%（95%CI 7.1 - 23.4），接受皮肤感染治疗的多44.4%（95%CI 36.5 - 51.2）。
结论
大多数儿科患者在有限的时间内接受了轻度疾病的治疗。尽管AD在较年轻年龄段的患病率较高，但这些儿科患者接受强效外用糖皮质激素治疗的可能性最小。男性和早发型AD与长期治疗以及强效外用糖皮质激素、抗组胺药和皮肤感染的治疗相关，且可能是其潜在预测因素，这对于个性化预后、医疗保健规划和未来AD预防试验可能具有临床实用价值。
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