OBJECTIVES:

To explore the racial and age-related disparity in disease severity and drug utilization in new AD patients.

METHODS:

Optum® de-identified Market Clarity Dataset, which links medical, and pharmacy claims with EHR data was used for this analysis. It included patients diagnosed between 1^st Jan 2017 to 31^st Dec 2020 who were continuously eligible for 3 years pre and 12 months post-index. Patients previously diagnosed with AD were excluded. Disease severity terms were extracted from the physician’s notes using Natural Language Processing (NLP). Based on the disease severity at the time of diagnosis and 12 months post index, racial and age-related disparities were evaluated. We also investigated the utilization of new vs traditional therapies by race. Further statistical tests would be applied to analyze the level of significance.

RESULTS:

Of the 2,954 incident patients, 68% were pediatric, 19% were African Americans and 57% were whites. Compared to 33% of whites, 50% of African Americans had AD in moderate to severe stage at the time of diagnosis. Results after a year showed that only 31% of whites had moderate to severe AD, compared to 53% of African Americans. Also, more African American children developed AD compared to White children at both baseline (67% vs 65%) and one year post follow up (69% vs 65%). Pediatric patients showed milder (67%) form of AD compared to adults (47%) at the time of diagnosis. African Americans were less likely than White patients to receive Crisaborole, Pimecrolimus, Dexamethasone and Prednisone except for hydrocortisone. No difference in utilization of Dupiuimab and Tacrolimus was observed between African Americans and whites.

CONCLUSIONS:

African Americans were affected severely whereas prevalence of AD was found to be more in pediatric population. African Americans were also found to have lower access to newer therapies as compared to whites.