The Challenge of Managing Atopic Dermatitis in the United States.

Background Atopic dermatitis is a chronic inflammatory skin disease that affects up to 13% of children and 10% of adults in the United States. Among patients and their families, atopic dermatitis has a considerable effect on quality of life and represents a substantial economic burden. Objective To describe the impact and challenges of atopic dermatitis and to provide nondermatologists in the healthcare community an enhanced understanding of atopic dermatitis to facilitate treatment and pharmacy benefit discussions. Discussion Atopic dermatitis is a heterogeneous disease, and its diagnosis is hampered by a lack of objective diagnostic criteria. The current management guidelines address the distinct clinical phenotypes as a single disease and do not incorporate recent clinical advances, such as the targeting of specific inflammatory processes. The treatment guidelines for atopic dermatitis are complex and challenge healthcare providers, patients, and caregivers. Novel treatments can provide additional therapeutic options for patients with atopic dermatitis. Conclusions Treatment options for atopic dermatitis are expanding with the development of novel anti-inflammatory therapies. An increased understanding of these advancements is necessary to optimize care for patients with atopic dermatitis.

[1]  J. Peter,et al.  Institute for Clinical and Economic Review , 2021, The Right Price.

[2]  J. Silverberg,et al.  Baricitinib in adult patients with moderate‐to‐severe atopic dermatitis: A phase 2 parallel, double‐blinded, randomized placebo‐controlled multiple‐dose study , 2018, Journal of the American Academy of Dermatology.

[3]  A. Muraro,et al.  Consensus‐based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II , 2018, Journal of the European Academy of Dermatology and Venereology : JEADV.

[4]  D. Margolis,et al.  Epidemiology of atopic dermatitis in adults: Results from an international survey , 2018, Allergy.

[5]  A. Muraro,et al.  Consensus‐based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I , 2018, Journal of the European Academy of Dermatology and Venereology : JEADV.

[6]  C. Flohr,et al.  Efficacy and safety of lebrikizumab (an anti‐IL‐13 monoclonal antibody) in adults with moderate‐to‐severe atopic dermatitis inadequately controlled by topical corticosteroids: A randomized, placebo‐controlled phase II trial (TREBLE) , 2018, Journal of the American Academy of Dermatology.

[7]  M. Lebwohl,et al.  Efficacy and safety of fezakinumab (an IL‐22 monoclonal antibody) in adults with moderate‐to‐severe atopic dermatitis inadequately controlled by conventional treatments: A randomized, double‐blind, phase 2a trial , 2018, Journal of the American Academy of Dermatology.

[8]  S. Feldman,et al.  A safety review of the medications used to treat atopic dermatitis , 2018, Expert opinion on drug safety.

[9]  L. Kemény,et al.  Adult Atopic Dermatitis is Associated with Increased Aortic Stiffness , 2018, American Journal of Clinical Dermatology.

[10]  R. Emsley,et al.  Intentional and Unintentional Medication Non-Adherence in Psoriasis: The Role of Patients’ Medication Beliefs and Habit Strength , 2017, The Journal of investigative dermatology.

[11]  J. Silverberg,et al.  Atopic dermatitis yardstick: Practical recommendations for an evolving therapeutic landscape. , 2018, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[12]  J. Gelfand,et al.  The burden of atopic dermatitis in US adults: Health care resource utilization data from the 2013 National Health and Wellness Survey , 2018, Journal of the American Academy of Dermatology.

[13]  J. Silverberg,et al.  A Phase 2b Dose-Ranging Efficacy and Safety Study of Tralokinumab in Adult Patients with Moderate to Severe Atopic Dermatitis , 2018 .

[14]  M. Lebwohl,et al.  Expert Perspectives on Management of Moderate-to-Severe Atopic Dermatitis: A Multidisciplinary Consensus Addressing Current and Emerging Therapies. , 2017, The journal of allergy and clinical immunology. In practice.

[15]  Timothy W. Smith,et al.  Topical treatment utilization for patients with atopic dermatitis in the United States, and budget impact analysis of crisaborole ointment, 2% , 2017, Journal of medical economics.

[16]  J. Fowler,et al.  Long‐term safety of crisaborole ointment 2% in children and adults with mild to moderate atopic dermatitis , 2017, Journal of the American Academy of Dermatology.

[17]  Alvin W. Li,et al.  Topical Corticosteroid Phobia in Atopic Dermatitis: A Systematic Review , 2017, JAMA dermatology.

[18]  S. Sullivan,et al.  Economic Evaluation of Dupilumab for the Treatment of Moderate-to-Severe Atopic Dermatitis in Adults , 2017, Dermatology and Therapy.

[19]  K. Kabashima,et al.  Efficacy and safety of ustekinumab in Japanese patients with severe atopic dermatitis: a randomized, double‐blind, placebo‐controlled, phase II study , 2017, The British journal of dermatology.

[20]  J. Gelfand,et al.  Impact of atopic dermatitis on health‐related quality of life and productivity in adults in the United States: An analysis using the National Health and Wellness Survey , 2017, Journal of the American Academy of Dermatology.

[21]  J. Chao,et al.  Burden of Atopic Dermatitis in the United States: Analysis of Healthcare Claims Data in the Commercial, Medicare, and Medi-Cal Databases , 2017, Advances in Therapy.

[22]  V. Nambudiri,et al.  Research Techniques Made Simple: Cost-Effectiveness Analysis. , 2017, The Journal of investigative dermatology.

[23]  K. Heitmiller,et al.  An Update on the Pathophysiology of Atopic Dermatitis. , 2017, Dermatologic clinics.

[24]  J. Piercy,et al.  Discordance Between Physician- and Patient-Reported Disease Severity in Adults with Atopic Dermatitis: A US Cross-Sectional Survey , 2017, American Journal of Clinical Dermatology.

[25]  Thomas Bieber,et al.  Clinical phenotypes and endophenotypes of atopic dermatitis: Where are we, and where should we go? , 2017, The Journal of allergy and clinical immunology.

[26]  M. Boguniewicz,et al.  Current guidelines for the evaluation and management of atopic dermatitis: A comparison of the Joint Task Force Practice Parameter and American Academy of Dermatology guidelines , 2017, The Journal of allergy and clinical immunology.

[27]  D. Leung,et al.  Assessing the current treatment of atopic dermatitis: Unmet needs. , 2017, The Journal of allergy and clinical immunology.

[28]  S. Feldman,et al.  Treatment Adherence Intervention Studies in Dermatology and Guidance on How to Support Adherence , 2017, American Journal of Clinical Dermatology.

[29]  M. Suárez-Fariñas,et al.  Efficacy and safety of ustekinumab treatment in adults with moderate‐to‐severe atopic dermatitis , 2017, Experimental dermatology.

[30]  M. Ardeleanu,et al.  Two Phase 3 Trials of Dupilumab versus Placebo in Atopic Dermatitis. , 2017, The New England journal of medicine.

[31]  Erika Sevetson,et al.  The Burden of Atopic Dermatitis: Summary of a Report for the National Eczema Association. , 2017, The Journal of investigative dermatology.

[32]  J. Silverberg,et al.  Increasing Comorbidities Suggest that Atopic Dermatitis Is a Systemic Disorder. , 2017, The Journal of investigative dermatology.

[33]  L. Strowd,et al.  The Future of Atopic Dermatitis Treatment. , 2017, Advances in experimental medicine and biology.

[34]  J. Thyssen,et al.  Anti-Interleukin-31 Receptor A Antibody for Atopic Dermatitis. , 2017, The New England journal of medicine.

[35]  S. Feldman,et al.  Adherence in Atopic Dermatitis. , 2019, Advances in experimental medicine and biology.

[36]  M. Lebwohl,et al.  Efficacy and safety of crisaborole ointment, a novel, nonsteroidal phosphodiesterase 4 (PDE4) inhibitor for the topical treatment of atopic dermatitis (AD) in children and adults. , 2016, Journal of the American Academy of Dermatology.

[37]  A. Qureshi,et al.  Research Gaps in Quality of Life and Economic Burden of Atopic Dermatitis: The National Eczema Association Burden of Disease Audit. , 2016, JAMA dermatology.

[38]  E. Simpson,et al.  Assessing the New and Emerging Treatments for Atopic Dermatitis. , 2016, Seminars in cutaneous medicine and surgery.

[39]  Stephan Weidinger,et al.  Atopic dermatitis , 2016, The Lancet.

[40]  S. Feldman,et al.  A review of patient adherence to topical therapies for treatment of atopic dermatitis. , 2015, Cutis.

[41]  J. Silverberg Health Care Utilization, Patient Costs, and Access to Care in US Adults With Eczema: A Population-Based Study. , 2015, JAMA dermatology.

[42]  A. Hebert,et al.  Diagnosis of Atopic Dermatitis: Mimics, Overlaps, and Complications , 2015, Journal of clinical medicine.

[43]  J. Ring,et al.  Safety and Efficacy of Pimecrolimus in Atopic Dermatitis: A 5-Year Randomized Trial , 2015, Pediatrics.

[44]  J. Kichler,et al.  Psoriasis in childhood: effective strategies to improve treatment adherence , 2015, Psoriasis.

[45]  S. Takeuchi,et al.  Poor adherence to oral and topical medication in 3096 dermatological patients as assessed by the Morisky Medication Adherence Scale-8 , 2014, The British journal of dermatology.

[46]  P. Audet,et al.  A Review of Approaches for the Management of Specialty Pharmaceuticals in the United States , 2014, PharmacoEconomics.

[47]  S. Feldman,et al.  Guidelines of care for the management of atopic dermatitis: section 3. Management and treatment with phototherapy and systemic agents. , 2014, Journal of the American Academy of Dermatology.

[48]  S. Feldman,et al.  Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies. , 2014, Journal of the American Academy of Dermatology.

[49]  J. Silverberg,et al.  Associations of Childhood Eczema Severity: A US Population-Based Study , 2014, Dermatitis : contact, atopic, occupational, drug.

[50]  Simon Francis Thomsen,et al.  Atopic Dermatitis: Natural History, Diagnosis, and Treatment , 2014, ISRN allergy.

[51]  S. Feldman,et al.  Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. , 2014, Journal of the American Academy of Dermatology.

[52]  S. Sullivan,et al.  Budget impact analysis-principles of good practice: report of the ISPOR 2012 Budget Impact Analysis Good Practice II Task Force. , 2014, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[53]  J. Silverberg,et al.  Adult eczema prevalence and associations with asthma and other health and demographic factors: a US population-based study. , 2013, The Journal of allergy and clinical immunology.

[54]  E. Simpson,et al.  Mental health comorbidity in patients with atopic dermatitis. , 2013, The Journal of allergy and clinical immunology.

[55]  S. Spector,et al.  Atopic dermatitis: a practice parameter update 2012. , 2013, The Journal of allergy and clinical immunology.

[56]  M. Chan-yeung,et al.  Atopic dermatitis in a high-risk cohort: natural history, associated allergic outcomes, and risk factors. , 2013, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[57]  E. Simpson Comorbidity in Atopic Dermatitis , 2012, Current Dermatology Reports.

[58]  L. Misery,et al.  Topical corticosteroid phobia in atopic dermatitis: a study of its nature, origins and frequency , 2011, The British journal of dermatology.

[59]  M. Chren,et al.  Quality-of-life outcomes and measurement in childhood atopic dermatitis. , 2010, Immunology and allergy clinics of North America.

[60]  J. Spergel,et al.  From atopic dermatitis to asthma: the atopic march. , 2010, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[61]  Muhammad Shahrukh,et al.  Burden of skin diseases , 2009, Expert review of pharmacoeconomics & outcomes research.

[62]  D. Stern Benefit design innovations to manage specialty pharmaceuticals. , 2008, Journal of managed care pharmacy : JMCP.

[63]  Timothy A. Dall,et al.  The burden of skin diseases: 2004 a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology. , 2006, Journal of the American Academy of Dermatology.

[64]  P. Beattie,et al.  A comparative study of impairment of quality of life in children with skin disease and children with other chronic childhood diseases , 2006, The British journal of dermatology.

[65]  M. Boguniewicz,et al.  Tacrolimus Ointment 0.03% Is Safe and Effective for the Treatment of Mild to Moderate Atopic Dermatitis in Pediatric Patients: Results From a Randomized, Double-Blind, Vehicle-Controlled Study , 2005, Pediatrics.

[66]  J. Sung,et al.  Health Plan Budget Impact Analysis for Pimecrolimus , 2005, Journal of Managed Care Pharmacy.

[67]  M. Chren,et al.  Effects of Atopic Dermatitis on Young American Children and Their Families , 2004, Pediatrics.

[68]  P. Beattie,et al.  Parental knowledge of topical therapies in the treatment of childhood atopic dermatitis , 2003, Clinical and experimental dermatology.

[69]  M. Boguniewicz,et al.  Safety and efficacy of pimecrolimus (ASM 981) cream 1% in the treatment of mild and moderate atopic dermatitis in children and adolescents. , 2002, Journal of the American Academy of Dermatology.

[70]  R. Langley,et al.  Tacrolimus ointment for the treatment of atopic dermatitis in adult patients: part I, efficacy. , 2001, Journal of the American Academy of Dermatology.

[71]  A. Fleischer,et al.  Tacrolimus ointment for the treatment of atopic dermatitis in adult patients: part II, safety. , 2001, Journal of the American Academy of Dermatology.