Treatment patterns of pediatric patients with atopic dermatitis: A claims data analysis

Amy S. Paller, Elaine C. Siegfried, Francis Vekeman, Abhijit Gadkari, Mandeep Kaur, Usha G. Mallya, Julie Héroux, Raymond Miao, Paola Mina-Osorio*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background: Real-world evidence on treatment patterns of pediatric patients with atopic dermatitis (AD) is sparse. Objective: To assess current treatment patterns in pediatric AD patients. Methods: Retrospective observational analysis of commercial insurance and Medicaid administrative claims data (January 2011-December 2016) for pediatric AD patients, stratified by age and provider type. Results: The analytic sample comprised 607,258 pediatric AD patients. Median observation period was 30.3 months. Overall, 78.6% were prescribed ≥1 AD medication; 86.7% were prescribed topical corticosteroids, and 5.4% were prescribed a calcineurin inhibitor. Systemic corticosteroids (SCSs) were prescribed for 24.4% of patients, 51.8% of whom did not have asthma or allergic comorbidities. Of the 46.6% prescribed an antihistamine and 16.2% prescribed montelukast, 62.0% and 41.3%, respectively, did not have asthma or allergic comorbidities. Systemic immunosuppressants were rarely prescribed (<0.5%). Higher potency topical corticosteroid and SCS use increased with age. Treatment patterns varied by provider type; specialists were more likely to prescribe higher potency topicals and/or systemics, regardless of patient age. A minority of patients were treated by or referred to a specialist. Limitations: Identification of AD patients relied on billing diagnoses; the disease severity was proxied by the treatment prescribed. Conclusion: Results indicate that SCSs, despite known risks, and other medications with disproven efficacy in AD are frequently prescribed, suggesting a need for safer and more effective alternatives.

Original languageEnglish (US)
Pages (from-to)651-660
Number of pages10
JournalJournal of the American Academy of Dermatology
Volume82
Issue number3
DOIs
StatePublished - Mar 2020

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Keywords

  • adolescents
  • atopic dermatitis
  • children
  • eczema
  • infants
  • systemic treatment
  • topical calcineurin inhibitors
  • topical corticosteroids
  • topical treatment

ASJC Scopus subject areas

  • Dermatology

Cite this

Paller, A. S., Siegfried, E. C., Vekeman, F., Gadkari, A., Kaur, M., Mallya, U. G., Héroux, J., Miao, R., & Mina-Osorio, P. (2020). Treatment patterns of pediatric patients with atopic dermatitis: A claims data analysis. Journal of the American Academy of Dermatology, 82(3), 651-660. https://doi.org/10.1016/j.jaad.2019.07.105