Severe Atopic Dermatitis In Spain: A Real-Life Observational Study.

Area of Science:

• Dermatology
• Epidemiology
• Pharmacology

Background:

• Severe atopic dermatitis (AD) significantly impacts patients' quality of life.
• Understanding the epidemiology and treatment patterns of severe AD in real-world clinical practice is crucial for optimizing patient care.

Purpose of the Study:

• To determine the epidemiology of severe atopic dermatitis (AD).
• To characterize the treatments prescribed for severe AD in children and adults within usual clinical practice.
• To analyze the prevalence of comorbidities associated with severe AD.

Main Methods:

• An observational, retrospective study involving the review of medical records of Spanish patients aged six years and older diagnosed with severe AD between 2013 and 2017.
• Patients were categorized into three age groups: 6-12 years, 13-18 years, and over 18 years.
• Data collected included AD prevalence, comorbidity profiles, and treatment duration over a five-year follow-up period.

Main Results:

• A total of 2323 patients with severe AD were included. The overall prevalence of severe AD was 0.10%, with variations across age groups (0.39% in 6-12 years, 0.23% in 13-18 years, 0.07% in >18 years).
• Asthma and anxiety were the most frequent comorbidities, particularly in younger age groups. General comorbidity scores increased with age.
• Oral corticosteroids were widely used across all age groups. Cyclosporine was the most prescribed immunosuppressant, followed by azathioprine and methotrexate. Biologic agents were used in 5.8% of patients.

Conclusions:

• Severe atopic dermatitis (AD) is associated with significant comorbidities, notably in psychological, immunoallergic, and cardiovascular domains.
• Cyclosporine emerged as the most utilized immunosuppressant for severe AD management.
• Variability was observed in the prescription and duration of treatments for severe AD, highlighting potential areas for treatment guideline refinement.