Pereira Manuel P, Stevanovic Katarina, Kocatürk Emek, Meesch Cathrin, van Hofman Ingrid, Vaswani Prema S, Bernstein Jonathan A, Bruscky Dayanne, Chong-Neto Herberto J, Chu Chia-Yu, Criado Roberta Fachini Jardim, Ensina Luis Felipe, Giménez-Arnau Ana M, Godse Kiran, Gotua Maia, Gregoriou Stamatios, Kulthanan Kanokvalai, Mortz Charlotte G, Mitrevska Natasa Teovska, Özkaya Esen, Pudasaini Prajwal, Felix Mara Morelo Rocha, Pérez Catalina Rincón, Parisi Claudio Alberto Salvador, Ramón Gonzalo N, Vakirlis Efstratios, Zhao Zuotao, Beck Lisa A, de Bruin-Weller Marjolein, Cork Michael, Katoh Norito, Werfel Thomas, Worm Margitta, Wollenberg Andreas, Zuberbier Torsten
Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.
J Dtsch Dermatol Ges. 2025 Sep;23(9):1116-1124. doi: 10.1111/ddg.15728. Epub 2025 Jun 8.
Systemic treatment of pregnant/breastfeeding atopic dermatitis (AD) patients is challenging due to limited safety data. We explored treatment practices with systemic agents, including the guideline-recommended cyclosporine as the first systemic choice as well as emerging therapies, in this vulnerable population.
The Global Allergy and Asthma Excellence Network (GALEN) ADCARE initiative collected data from physicians worldwide who treat pregnant women with AD. Physicians completed an electronic questionnaire on the use of systemic agents in pregnant/breastfeeding AD patients.
103 physicians from 32 countries completed the survey, primarily dermatologists (n = 48) or allergologists (n = 43). Antihistamines were the systemic drug most often considered to be used during pregnancy/breastfeeding (n = 73/81, 90.1%), with fewer physicians considering the use of systemic agents for the first trimester compared to later stages of pregnancy. For acute flares, systemic corticosteroids (n = 34/80, 42.5%) were preferred, followed by biologics and antihistamines (each n = 15/80, 18.8%). Although the guideline-recommended cyclosporine is sometimes considered for AD during pregnancy (n = 38/81, 46.9%), it was rarely considered as the preferred drug by physicians (n = 1/80, 1.25%).
Our study shows a misalignment between guideline recommendations and prescription patterns and highlights an unmet need for knowing and using the existing recommendations.
由于安全性数据有限，对患有特应性皮炎（AD）的孕妇/哺乳期妇女进行系统治疗具有挑战性。我们在这一脆弱人群中探索了使用全身用药的治疗方法，包括指南推荐的环孢素作为首选全身用药以及新兴疗法。
全球过敏与哮喘卓越网络（GALEN）的ADCARE倡议收集了全球治疗AD孕妇的医生的数据。医生们完成了一份关于在患有AD的孕妇/哺乳期妇女中使用全身用药的电子问卷。
来自32个国家的103名医生完成了调查，主要是皮肤科医生（n = 48）或过敏症专科医生（n = 43）。抗组胺药是孕期/哺乳期最常被考虑使用的全身用药（n = 73/81，90.1%），与妊娠后期相比，考虑在妊娠早期使用全身用药的医生较少。对于急性发作，全身用皮质类固醇（n = 34/80，42.5%）是首选，其次是生物制剂和抗组胺药（各n = 15/80，18.8%）。尽管指南推荐的环孢素在孕期AD中有时会被考虑使用（n = 38/81，46.9%），但很少被医生视为首选药物（n = 1/80，1.25%）。
我们的研究表明指南推荐与处方模式之间存在不一致，并突出了对了解和使用现有推荐的未满足需求。
