Use patterns of systemic immunomodulators in the United States before and after dupilumab approval in adults with atopic dermatitis. Issue 5 (28th December 2022)

• Record Type: Journal Article
• Authors: Anand, Priyanka; Schneeweiss, Sebastian; Mostaghimi, Arash; Schneeweiss, Maria C.
• Is Part Of: Pharmacoepidemiology and drug safety. Volume 32:Issue 5(2023)
• Page Start: 567
• Page End: 576
• Publication Date: 2022-12-28
• Subjects: atopic dermatitis -- azathioprine -- cyclosporine -- dupilumab -- immuno‐modulating drugs -- methotrexate -- mycophenolate -- utilization; Pharmacoepidemiology -- Periodicals; Chemotherapy -- Periodicals; Epidemiology -- Periodicals; 615.705
• DOI: 10.1002/pds.5586
• Languages: English
• ISSNs: 1053-8569

Abstract

Abstract: Purpose: The patterns of dupilumab use, the first systemic drug approved for the treatment of atopic dermatitis (AD), is not well understood in the context of off‐label systemic medications. Objective: To describe patterns of prescribing, switching and discontinuing systemic AD drugs, before and after the approval of dupilumab and understand variables associated with dupilumab prescription. Methods: Using longitudinal claims data, we identified patients with AD who initiated a systemic therapy (dupilumab, cyclosporine, methotrexate, azathioprine, mycophenolate) from March 2015 to February 2021, with a washout period of 1 year. We used Sankey plots to visualize longitudinal patterns of use at 3, 6, and 12 months and logistic regression to determine associates of dupilumab prescription. Results: The number of patients starting systemic treatment increased from 319 before dupilumab approval to 1358 after. Dupilumab use increased from 72% to 84%. In 2019–2020, 36% of patients discontinued systemic treatment within a year compared to 62% in 2015–2016. 92% of patients who started dupilumab in 2020–2021 had received no other systemic treatment before. Patients <60 years and those who used steroid‐sparing topical treatments were more likely to receive dupilumab. Conclusion: Among new users of a systemic treatment for AD, dupilumab was most used treatment by far.