Table 2.
Treatment initiation pattern for atopic dermatitis.
| Treatment category | Pediatrics | Adults | p-value‡ | |||||
|---|---|---|---|---|---|---|---|---|
| 0–1 year (n = 286,178) | 2–5 years (n = 249,070) | 6–11 years (n = 263,880) | 12–17 years (n = 145,431) | 18–39 years (n = 451,924) | 40–59 years (n = 357,229) | ≥ 60 years (n = 257,300) | ||
| Medications at treatment initiation, mean (SD) | 1.30 (0.53) | 1.68 (0.70) | 1.81 (0.78) | 2.05 (0.85) | 2.02 (0.90) | 1.88 (0.84) | 1.77 (0.81) | < 0.001 |
| Prescription with ≥ 2 distinct medications | 76,835 (26.8) | 136,383 (54.8) | 155,244 (58.8) | 99,072 (68.1) | 294,143 (65.1) | 212,333 (59.4) | 138,912 (54.0) | < 0.001 |
| Type of medication at treatment initiation | ||||||||
| Topical treatment | ||||||||
| Corticosteroids* | 244,439 (85.4) | 184,337 (74.0) | 191,972 (72.7) | 104,294 (71.7) | 289,791 (64.1) | 207,966 (58.2) | 151,614 (58.9) | < 0.001 |
| Low | 216,612 (75.7) | 133,292 (53.5) | 114,994 (43.6) | 42,334 (29.1) | 97,552 (21.6) | 60,366 (16.9) | 40,499 (15.7) | < 0.001 |
| Medium | 25,996 (9.1) | 41,946 (16.8) | 53,685 (20.3) | 30,811 (21.2) | 76,151 (16.9) | 55,475 (15.5) | 38,919 (15.1) | 0.005 |
| High | 5,664 (2.0) | 14,782 (5.9) | 33,512 (12.7) | 42,766 (29.4) | 144,545 (32.0) | 102,435 (28.7) | 78,506 (30.5) | < 0.001 |
| Calcineurin inhibitors | 335 (0.1) | 9551 (3.8) | 16,009 (6.1) | 11,491 (7.9) | 47,167 (10.4) | 33,958 (9.5) | 21,037 (8.2) | < 0.001 |
| Systemic treatment | ||||||||
| Antihistamines | 109,426 (38.2) | 172,424 (69.2) | 186,313 (70.6) | 110,679 (76.1) | 327,085 (72.4) | 245,826 (68.8) | 168,199 (65.4) | < 0.001 |
| Corticosteroids | 13,605 (4.8) | 39,947 (16.0) | 67,498 (25.6) | 65,849 (45.3) | 228,114 (50.5) | 169,640 (47.5) | 105,844 (41.1) | < 0.001 |
| Oral | 12,953 (4.5) | 38,946 (15.6) | 65,717 (24.9) | 62,635 (43.1) | 209,488 (46.4) | 148,793 (41.7) | 86,826 (33.7) | < 0.001 |
| Median daily dose (IQR)† (mg) | 5.0 (5.3) | 6.0 (5.0) | 7.5 (5.0) | 10.0 (5.0) | 10.0 (7.5) | 10.0 (7.5) | 10.0 (7.5) | |
| Parenteral | 1032 (0.4) | 2111 (0.9) | 5178 (2.0) | 11,958 (8.2) | 64,414 (14.3) | 65,299 (18.3) | 47,059 (18.3) | < 0.001 |
| Immunosuppressants | ||||||||
| Cyclosporine | 6 (0.0) | 18 (0.0) | 118 (0.0) | 428 (0.3) | 3843 (0.9) | 3632 (1.0) | 2396 (0.9) | < 0.001 |
| Median daily dose (IQR)† (mg) | 50.0 (10.0) | 50.0 (50.0) | 100.0 (50.0) | 100.0 (150.0) | 100.0 (125.0) | 100.0 (150.0) | 100.0 (150.0) | |
| Methotrexate | 0 | 5 (0.0) | 6 (0.0) | 5 (0.0) | 33 (0.0) | 49 (0.0) | 38 (0.0) | < 0.001 |
| Oral | 0 | 4 (0.0) | 5 (0.0) | 4 (0.0) | 30 (0.0) | 44 (0.0) | 36 (0.0) | < 0.001 |
| Median weekly dose (IQR)† (mg) | – | 10.0 (2.5) | 5.0 (7.5) | 11.3 (13.8) | 10.0 (5.0) | 7.5 (5.0) | 5.0 (6.9) | |
| Parenteral | 0 | 1 (0.0) | 1 (0.0) | 1 (0.0) | 3 (0.0) | 5 (0.0) | 2 (0.0) | 0.084 |
| Azathioprine | 0 | 0 | 1 (0.0) | 56 (0.0) | 131 (0.0) | 94 (0.0) | 81 (0.0) | < 0.001 |
| Mycophenolate mofetil | 0 | 1 (0.0) | 0 | 4 (0.0) | 6 (0.0) | 13 (0.0) | 12 (0.0) | < 0.01 |
| Interferon-γ | 0 | 0 | 1 (0.0) | 1 (0.0) | 1 (0.0) | 2 (0.0) | 0 | 0.329 |
| Intravenous immunoglobulin | 4 (0.0) | 6 (0.0) | 3 (0.0) | 4 (0.0) | 9 (0.0) | 6 (0.0) | 2 (0.0) | 0.723 |
| Dupilumab | 0 | 0 | 0 | 0 | 0 | 0 | 0 | n/a |
| Montelukast | 4598 (1.6) | 12,335 (5.0) | 12,126 (4.6) | 2588 (1.8) | 5222 (1.2) | 5177 (1.5) | 2665 (1.0) | < 0.001 |
| Alitretinoin | 0 | 1 (0.0) | 5 (0.0) | 27 (0.0) | 671 (0.2) | 874 (0.2) | 479 (0.2) | < 0.001 |
| Phototherapy | 245 (0.1) | 741 (0.3) | 2327 (0.9) | 2663 (1.8) | 10,274 (2.3) | 5018 (1.4) | 2452 (1.0) | < 0.001 |
Values are numbers (percentages) unless stated otherwise.
SD standard deviation.
*Topical corticosteroids were categorized into three levels based on the WHO potency-based classification of topical corticosteroids: low (class 6–7), medium (class 3–5) and high (class 1–2).
†Median daily dose during the observational period. For methotrexate, the median weekly doses were calculated.
‡The p-values denote comparison between pediatrics and adults.