OBJECTIVES

Atopic dermatitis (AD) is a relapsing chronic inflammatory skin condition characterized by pruritus and eczematous lesions, affecting 20% of children and 2–8% of adults. Yet, burden of mild-moderate AD has not been well-studied.

METHODS

Pediatric (0-14 years, inclusive) mild-moderate AD (pM2M-AD) patients were identified in the Swedish national prescribed drug (primary and secondary care) and patient (secondary care only) registers between 2009–2017. Patients were included based on topical corticosteroids (TCS) dispensations and excluded if they had severe AD (secondary-care diagnosis, systemic treatment, or topical calcineurin inhibitor) or other TCS-indicated diseases. First TCS dispensation was defined as patients’ index date. pM2M-AD patients were matched 1:1 on age and gender to non-pM2M-AD controls. Comorbidity burden and asthma incidence-rate ratio were assessed at and after index, respectively. Healthcare resource use and associated costs (secondary-care and prescription costs) were calculated 1- and 5-years following index (2018 Euros). Each outcome was compared between pM2M-AD patients and controls, evaluated at alpha=5% using t-tests. This study was approved by the Swedish Ethical Review Board (2019-02986).

RESULTS

The pM2M-AD cohort included 59,134 patients (52.3% male) with mean age and follow-up duration of 4.8 years and 4.3 years, respectively. In pM2M-AD patients, comorbidities were more prevalent and had a 97.3% increased risk of developing asthma compared to controls. pM2M-AD patients had 24,688 [2,184] more out-patient [in-patient] visits than controls after 1 year and 78,784 [4,008] after 5 years. Direct total health-care costs were 20.7 and €54.3 million higher after 1 and 5 years, respectively. All comparisons were statistically significant.

CONCLUSIONS

Considerable patient and economic burden was identified in this study of pediatric mild-moderate AD patients including high rates of secondary-care usage, highlighting the need for novel, effective therapies. Economic burden may be underestimated due to a lack of primary care healthcare contact data and probable exclusion of some moderately severe patients.