TY - JOUR
T1 - Prescribing practices for systemic agents in the treatment of severe pediatric atopic dermatitis in the US and Canada
T2 - The PeDRA TREAT survey
AU - Totri, Christine R.
AU - Eichenfield, Lawrence F.
AU - Logan, Kirsty
AU - Proudfoot, Laura
AU - Schmitt, Jochen
AU - Lara-Corrales, Irene
AU - Sugarman, Jeffrey
AU - Tom, Wynnis
AU - Siegfried, Elaine
AU - Cordoro, Kelly
AU - Paller, Amy S.
AU - Flohr, Carsten
PY - 2017/2
Y1 - 2017/2
N2 - Background There is a paucity of literature to direct physicians in the prescribing of immunomodulators for patients with severe atopic dermatitis (AD). Objective To survey systemic agent prescribing practices for severe childhood AD among clinicians in the United States and Canada. Methods The TREatment of severe Atopic dermatitis in children Taskforce (TREAT), US&CANADA, a project of the Pediatric Dermatology Research Alliance (PeDRA), developed an online multiple-response survey to assess clinical practice, gather demographic information and details of systemic agent selection, and identify barriers to their use in patients with recalcitrant pediatric AD. Results In total, 133 of 290 members (45.9%) of the Society for Pediatric Dermatology completed the survey, and 115 of 133 (86.5%) used systemic treatment for severe pediatric AD. First-line drugs of choice were cyclosporine (45.2%), methotrexate (29.6%), and mycophenolate mofetil (13.0%). The most commonly used second-line agents were methotrexate (31.3%) and mycophenolate mofetil (30.4%); azathioprine was the most commonly cited third-line agent. The main factors that discouraged use of systemic agents were side-effect profiles (82.6%) and perceived risks of long-term toxicity (81.7%). Limitations Investigation of the sequence of systemic medications or combination systemic therapy was limited. Recall bias may have affected the results. Conclusion Great variation exists in prescribing practices among American and Canadian physicians using systemic agents for treatment of pediatric AD.
AB - Background There is a paucity of literature to direct physicians in the prescribing of immunomodulators for patients with severe atopic dermatitis (AD). Objective To survey systemic agent prescribing practices for severe childhood AD among clinicians in the United States and Canada. Methods The TREatment of severe Atopic dermatitis in children Taskforce (TREAT), US&CANADA, a project of the Pediatric Dermatology Research Alliance (PeDRA), developed an online multiple-response survey to assess clinical practice, gather demographic information and details of systemic agent selection, and identify barriers to their use in patients with recalcitrant pediatric AD. Results In total, 133 of 290 members (45.9%) of the Society for Pediatric Dermatology completed the survey, and 115 of 133 (86.5%) used systemic treatment for severe pediatric AD. First-line drugs of choice were cyclosporine (45.2%), methotrexate (29.6%), and mycophenolate mofetil (13.0%). The most commonly used second-line agents were methotrexate (31.3%) and mycophenolate mofetil (30.4%); azathioprine was the most commonly cited third-line agent. The main factors that discouraged use of systemic agents were side-effect profiles (82.6%) and perceived risks of long-term toxicity (81.7%). Limitations Investigation of the sequence of systemic medications or combination systemic therapy was limited. Recall bias may have affected the results. Conclusion Great variation exists in prescribing practices among American and Canadian physicians using systemic agents for treatment of pediatric AD.
KW - atopic dermatitis
KW - azathioprine
KW - cyclosporine
KW - methotrexate
KW - mycophenolate mofetil
KW - oral antimicrobials
KW - oral steroids
U2 - 10.1016/j.jaad.2016.09.021
DO - 10.1016/j.jaad.2016.09.021
M3 - Article
SN - 0190-9622
VL - 76
SP - 281
EP - 285
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 2
ER -