Systemic Corticosteroid Exposure in Patients with Atopic Dermatitis: A US Population-Based Study

Area of Science:

• Dermatology
• Pharmacology
• Real-world evidence studies

Background:

• Clinical guidelines advise against routine systemic corticosteroid use for atopic dermatitis (AD) due to adverse effects.
• Real-world adherence to these recommendations is not well-understood.

Purpose of the Study:

• To evaluate the real-world use and adherence to guidelines regarding systemic corticosteroid prescriptions in patients diagnosed with atopic dermatitis (AD).

Main Methods:

• Retrospective cohort study analyzing US healthcare claims data (Optum Clinformatics Data Mart Database).
• Two cohorts were established: an exposure cohort (first systemic corticosteroid use post-AD diagnosis) and a diagnosis-based cohort (first AD diagnosis).
• Patients aged ≥12 years with AD between 2017-2024 and continuous insurance were included, with specific exclusion criteria for other inflammatory diseases or significant medical history.

Main Results:

• In the exposure cohort (29,994 patients), 67.7% received short-term, 8.5% medium-term, and 23.9% long-term systemic corticosteroid therapy.
• Oral systemic corticosteroids accounted for 80.0% of prescriptions, while intramuscular formulations comprised 20.0%.
• The diagnosis-based cohort (80,647 patients) showed a 20.0% prevalence of systemic corticosteroid use within 6 months of AD diagnosis.

Conclusions:

• Systemic corticosteroids are frequently prescribed for atopic dermatitis (AD) patients in the United States.
• Current prescribing patterns indicate limited adherence to clinical guidelines recommending against routine use.
• There is a significant need to promote the adoption of corticosteroid-sparing therapies for managing AD.