OBJECTIVES: The objective of this research was to characterize real-world treatment patterns among bullous pemphigoid patients in diverse healthcare delivery settings in the United States (US).

METHODS: Patients from 6 specialty dermatology networks and 4 integrated delivery networks within the OMNY Health Database with any indication of bullous pemphigoid (ICD-10-CM: L12.0) from 2017-2023 were included. Demographic characteristics were tabulated at first diagnosis. Disease severity was characterized at the first measure. Percentages of patients with prescriptions for the following treatments were computed: topical corticosteroids (TC), systemic corticosteroids (SC), non-immunosuppressive agents, and immunosuppressants. Secular trends in annual treatment patterns were described.

RESULTS: Across all years, a total of 7,229 bullous pemphigoid patients were included. Distributions of gender (52% female) and race (87% white, 8% black, 5% other among known values) were tabulated. The mean (SD) age at first diagnosis was 73 (14). 23% of patients had a severity assessment (60% clear to mild/moderate), 15% had a pain intensity visual analog scale [mean (SD) = 1.35 (2.3)], and 13% had a body surface area percentage [mean (SD) = 18.03 (22.27)]. TC ranged from 53% to 72% from 2017 to 2023. SC ranged from 29% to 41%, peaking in 2021. Non-immunosuppressive agents increased from 30% in 2017 to 35% in 2023, and immunosuppressants ranged from 12% to 16%.

CONCLUSIONS: Results provide insights into real-world treatment patterns for bullous pemphigoid patients within a diverse set of US healthcare settings. Topical corticosteroids were the most utilized treatment observed. As new treatments are developed and introduced, future analyses would be helpful to understand uptake of therapies and prescription patterns among bullous pemphigoid patients at different severity stages.