34574 Systemic medication treatment patterns in adults with atopic dermatitis (AD): Results from the European Prospective Observational Study in Patients Eligible for Systemic Therapy for Atopic Dermatitis (EUROSTAD)

Abstract

Introduction: EUROSTAD (OBS14620) is an observational study of up to 60 months to characterize AD treatment in a real-world setting. Here, we describe systemic treatment-patterns in patients enrolled in EUROSTAD. Methods: Individuals with AD, ≥18 years old and eligible for systemic treatment, were enrolled. Initial study period was 18 months but was amended to 60 months. Treatment was prescribed by study investigators as per clinical practice. Follow-up population is defined as all patients who have completed ≥1 follow-up visit. Reported data is descriptive from the full-analysis set at 24 months. Results: 308 patients were enrolled (mean AD duration: 25.4 years). Most patients reported ≥1 systemic medication use at enrollment (92.5%). During follow-up (n = 295) most patients reported using either one (56.3%) or >1 (41.4%) systemic medication. Cyclosporin, dupilumab, corticosteroids and methotrexate were the most common systemic therapies. Most common reasons reported for treatment initiation were maintenance and exacerbation treatment (both 79.7%), while well-controlled disease (59.7%) and lack of efficacy (38.1%) were the most common reasons for discontinuation. Median duration of systemic treatment was between 1.1-13 months for the most common therapies (corticosteroids, 1.1 months (95% CI 1.0-1.5); cyclosporin, 5.4 months (4.2-6.6), methotrexate, 13.0 months [8.9-16.9]); median duration of dupilumab treatment was not reached because >50% of patients were still on dupilumab at 24 months. Conclusion: AD therapy was started for exacerbation or maintenance treatment and discontinued mainly due to lack of efficacy or well-controlled disease. Patients who initiated dupilumab were more likely to remain on dupilumab compared with other systemic therapies.