OBJECTIVES: The objective of this research was to characterize real-world treatment patterns of traditional and advanced therapies among atopic dermatitis (AD) patients in large dermatology specialty networks in the United States (US).

METHODS: Patients from four large dermatology networks within the OMNY Health Database with any indication of AD (diagnosis code: L20*) from 2012-2021 were included. Demographic characteristics were tabulated at first AD diagnosis. Percentages of patients with prescriptions for any of the following therapy classes were computed: systemic corticosteroids (SCS), systemic immunosuppressants (SIS), topical corticosteroids (TCS), dupilumab, phototherapy, topical calcineurin inhibitors (TCI), and crisaborole. Secular trends in annual treatment patterns were described.

RESULTS: Across all years, a total of 175,879 AD patients with prescription and procedure data were included. Distributions of gender (60% female), race (70% White, 14% Black, 16% Other among known categories), age (29% ≥ 60 years, 43% 20-60 years, 28% < 20 years), and region (47% Southeast, 20% West, 18% Mid-Atlantic/Northeast, 15% Midwest) were as expected. Patients prescribed TCS increased from 35% in 2012 to 62% in 2020. Prescription patterns for SCS displayed a steady increase from 2014 (1.4%) to 2019 (4.7%) followed by a slight decrease in subsequent years. Similarly, TCI use in patients started at 2% in 2012 and peaked at 7% in 2020 followed by a slight decrease. SIS, dupilumab, and phototherapy were used less commonly in patients, ranging from 0.1% to 0.6%, 0.2% to 2%, and 0.4% to 0.9%, respectively. Crisaborole use increased from 3% in 2017 to 8% in 2019 then decreased to 4% in 2021.

CONCLUSIONS: Results provide insights into real-world treatment patterns for AD within large US dermatology specialty networks. As new treatments are developed and introduced, future analyses would be helpful to understand uptake and disease severity in large dermatology populations.