Trends in Atopic Dermatitis Management: Comparison of 1990-1997 to 2003-2012.

Abstract

BACKGROUND:

Atopic dermatitis (AD) is primarily treated with topical therapies, systemic immunosuppressants, or adjunctive therapies.

OBJECTIVE:

As novel treatment approaches for AD emerge, we characterize AD treatment and examine trends in treatment over time.

METHODS:

Visits for AD were identified in the 2003-2012 National Ambulatory Medical Care Survey (NAMCS). We identified topical corticosteroids (TCS), antibiotics (Abx), antihistamines (AH), topical calcineurin inhibitors (TCI), and systemic immunosuppressants (SI) prescribed at AD visits.

RESULTS:

There were 990,000 annual visits for AD from 2003-2012 (3.2 visits/1000 people/year). TCS were the most frequently used medication (59% of visits). Topical calcineurin inhibitors (TCI) were the second most prescribed medication for AD among dermatologists (23% of visits), while antihistamines were second among all other physicians (16-44% of visits). Unlike other medications, use of TCIs decreased over time.

LIMITATIONS:

The NAMCS does not follow individual patients over time.

CONCLUSIONS:

TCI use has been decreasing. New topical AD treatments may provide an alternative to TCS, better treatment outcomes for moderate-to-severe atopic dermatitis, and an alternative to systemic antihistamines whose efficacy in AD is unproven and whose general use in AD management is discouraged by the American Academy of Dermatology. J Drugs Dermatol. 2018;17(2):135-140.

• Authors: Alice He, Steven R Feldman, Alan B Fleischer
• Journal: Journal of drugs in dermatology : JDD (J Drugs Dermatol) Vol. 17 Issue 2 Pg. 135-140 (Feb 01 2018) ISSN: 1545-9616 [Print] United States
• PMID: 29462220 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Adrenal Cortex Hormones
• Anti-Bacterial Agents
• Dermatologic Agents
• Immunosuppressive Agents

Topics

• Administration, Topical
• Adolescent
• Adrenal Cortex Hormones (administration & dosage)
• Adult
• Aged
• Ambulatory Care (trends)
• Anti-Bacterial Agents (administration & dosage)
• Dermatitis, Atopic (diagnosis, drug therapy, epidemiology)
• Dermatologic Agents (administration & dosage)
• Disease Management
• Female
• Humans
• Immunosuppressive Agents (administration & dosage)
• Male
• Middle Aged
• Surveys and Questionnaires
• Young Adult