Atopic dermatitis (AD or eczema) is a common
Description: Atopic dermatitis (AD or eczema) is a common inflammatory disease characterized by a filaggrin loss of function mutation, high immunoglobin-E levels, and upregulated cytokines Typically, severe AD is treated with immunomodulating agents
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slide1. Atopic dermatitis (AD or eczema) is a common inflammatory disease characterized by a filaggrin loss of function mutation, high immunoglobin-E levels, and upregulated cytokines
Typically, severe AD is treated with immunomodulating agents such as azathioprine, methotrexate, mycophenolate mofetil, and phototherapy. These medications are prescribed in AD as off-label treatments, lacking clear guidelines.
Dupilumab, a new monoclonal antibody drug, was recently FDA-approved for the treatment of AD. It functions by binding to the interleukin (IL)-4 alpha signaling complex, inhibiting the action of IL-4, and reducing cytokine levels.
AD disproportionally affects patients with skin of color, specifically patients who identify as Asian, or Black or African American.
We sought to characterize dupilumab prescription patterns for AD characterized by AD subtype and patient demographics in a large health care system. We found that patient racial characteristics as well as specific eczema diagnoses were associated with increased frequency of dupilumab prescriptions.
Our results suggest that patients who reported their race as African American or Black were more likely to have received a dupilumab prescription compared to White patients in our health care system. This result is surprising, given previous research demonstrating less outpatient dermatologic care and fewer biologic prescriptions among the population of Black AD patients
Future studies may consider exploring the possible factors contributing to the dupilumab prescription patterns we discovered, such as AD disease severity as a potential contributing factor and the role of insurance type in dupilumab prescribing frequency Contact: contact@ohdsi.org Background and Objective Results Conclusions There were 249 dupilumab prescriptions among 6421 patients
In our cohort, Black patients were approximately twice as likely to have received dupilumab for AD than were White patients.
Similarly, those diagnosed with atopic neurodermatitis were about twice as likely to have received dupilumab than those who were diagnosed with atopic dermatitis.
Conversely, those with other eczema diagnoses (including flexural eczema, nummular eczema, or vesicular eczema) were less likely to have received dupilumab than those with a most recent diagnosis of atopic neurodermatitis. We performed a retrospective, observational cohort study of patients receiving dupilumab for AD and other unspecified dermatitis diagnoses using electronic data from the University of Colorado Medical Campus and its affiliates between 3/28/2013-3/28/2021
Each patient characteristic (Table I) was assessed using logistic regression with the binary outcome of receiving Dupilumab or not.
Coding available on Github: https://github.com/CUDermEpiLabGroup/DupilumabADJMIRDerm_HealthDataCompass We did not analyze patients’ insurance status and type of insurance at the time of visit, which would have been useful to provide further clarity regarding prescribing relationships.
We also were unable to determine the severity of AD and therefore were unable to analyze if there was a relationship between severity of AD and likelihood of being prescribed dupilumab.
We were unable to assess for confounding diagnoses, where dupilumab may have been prescribed for a condition other than AD (asthma, nasal polyposis).
We did not look at type of health care provider prescribing dupilumab. Methods Limitations Prescribing Patterns of Dupilumab for Atopic Dermatitis in Adults A Retrospective, Observational Cohort Study Torunn E. Sivesind,1 Ani Oganesyan,2 Grace Bosma,3 Camille Hochheimer,3 Madeline J. Adelman,1 Lisa M. Schilling,4 Robert P. Dellavalle 5,6
1Department of Dermatology, University of Colorado School of Medicine, Aurora, CO 4Department of Medicine and Division of General Internal Medicine, Aurora, CO
2University of Colorado School of Medicine, Aurora, CO 5University of Colorado School of Medicine, Aurora, Colorado; Professor of Public Health, The Colorado School of Public Health, Aurora, CO
3Center for Innovative Design & Analysis, University of Colorado School of Public Health, Aurora, CO 6Dermatology Service, US Department of Veterans Affairs, Eastern Colorado Health Care System, Aurora, CO<br>
Typically, severe AD is treated with immunomodulating agents such as azathioprine, methotrexate, mycophenolate mofetil, and phototherapy. These medications are prescribed in AD as off-label treatments, lacking clear guidelines.
Dupilumab, a new monoclonal antibody drug, was recently FDA-approved for the treatment of AD. It functions by binding to the interleukin (IL)-4 alpha signaling complex, inhibiting the action of IL-4, and reducing cytokine levels.
AD disproportionally affects patients with skin of color, specifically patients who identify as Asian, or Black or African American.
We sought to characterize dupilumab prescription patterns for AD characterized by AD subtype and patient demographics in a large health care system. We found that patient racial characteristics as well as specific eczema diagnoses were associated with increased frequency of dupilumab prescriptions.
Our results suggest that patients who reported their race as African American or Black were more likely to have received a dupilumab prescription compared to White patients in our health care system. This result is surprising, given previous research demonstrating less outpatient dermatologic care and fewer biologic prescriptions among the population of Black AD patients
Future studies may consider exploring the possible factors contributing to the dupilumab prescription patterns we discovered, such as AD disease severity as a potential contributing factor and the role of insurance type in dupilumab prescribing frequency Contact: contact@ohdsi.org Background and Objective Results Conclusions There were 249 dupilumab prescriptions among 6421 patients
In our cohort, Black patients were approximately twice as likely to have received dupilumab for AD than were White patients.
Similarly, those diagnosed with atopic neurodermatitis were about twice as likely to have received dupilumab than those who were diagnosed with atopic dermatitis.
Conversely, those with other eczema diagnoses (including flexural eczema, nummular eczema, or vesicular eczema) were less likely to have received dupilumab than those with a most recent diagnosis of atopic neurodermatitis. We performed a retrospective, observational cohort study of patients receiving dupilumab for AD and other unspecified dermatitis diagnoses using electronic data from the University of Colorado Medical Campus and its affiliates between 3/28/2013-3/28/2021
Each patient characteristic (Table I) was assessed using logistic regression with the binary outcome of receiving Dupilumab or not.
Coding available on Github: https://github.com/CUDermEpiLabGroup/DupilumabADJMIRDerm_HealthDataCompass We did not analyze patients’ insurance status and type of insurance at the time of visit, which would have been useful to provide further clarity regarding prescribing relationships.
We also were unable to determine the severity of AD and therefore were unable to analyze if there was a relationship between severity of AD and likelihood of being prescribed dupilumab.
We were unable to assess for confounding diagnoses, where dupilumab may have been prescribed for a condition other than AD (asthma, nasal polyposis).
We did not look at type of health care provider prescribing dupilumab. Methods Limitations Prescribing Patterns of Dupilumab for Atopic Dermatitis in Adults A Retrospective, Observational Cohort Study Torunn E. Sivesind,1 Ani Oganesyan,2 Grace Bosma,3 Camille Hochheimer,3 Madeline J. Adelman,1 Lisa M. Schilling,4 Robert P. Dellavalle 5,6
1Department of Dermatology, University of Colorado School of Medicine, Aurora, CO 4Department of Medicine and Division of General Internal Medicine, Aurora, CO
2University of Colorado School of Medicine, Aurora, CO 5University of Colorado School of Medicine, Aurora, Colorado; Professor of Public Health, The Colorado School of Public Health, Aurora, CO
3Center for Innovative Design & Analysis, University of Colorado School of Public Health, Aurora, CO 6Dermatology Service, US Department of Veterans Affairs, Eastern Colorado Health Care System, Aurora, CO<br>