Patient Preferences in Atopic Dermatitis Treatment

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Patients with severe to moderate atopic dermatitis (AD) bear in mind efficacy and adverse effects (AEs) when considering treatment options, according to data presented in a poster at the Maui Derm Hawaii 2024 conference in Wailea, Hawaii.¹

The poster authors claimed that despite variations in newer treatment options for patients with AD, patient preferences for different treatment attributes are not well characterized in the US, citing a 2022 study.²

For the research presented at Maui Derm, a group of 300 people completed an online survey in a discrete choice experiment. The mean age of the participants was 45 years, 78% were white, and 70% were women.

Eligible participants were adults (≥18 years) who had (1) been diagnosed with AD for at least one year, (2) self-reported moderate-to-severe AD or experience with systemic therapy, and (3) experienced inadequate response to topical treatments, according to the poster.

Approximately 50% of those surveyed received their first AD treatment of any kind 5 or more years before, had experienced severe symptoms, and had experience with systemic therapy, the researchers reported.

The participants preferred treatments with higher efficacy, lower risk of AEs, and less frequent blood tests. Frequency and mode of administration (ie, oral vs. injectable) did not impact preferences.

Participants were willing to trade off varying chances of achieving meaningful itch control to avoid AE risks, the researchers reported.

Treatment attributes the patients most considered, from high to low relative importance, were:

• Itch control (38%)
• Risk of cancer (23%)
• Risk of respiratory infections (18%)
• Risk of heart problems (11%)
• Sustained improvement in skin appearance (5%)
• Blood test frequency (3%)
• Frequency and mode of administration (2%)

On average, participants were willing to accept a reduction of 35.4, 17.7, and 1.2 percentage points in the probability of achieving itch control to receive a treatment with 1 percentage point less risk of cancer, heart problems, and respiratory infections, respectively, according to the researchers.

The researchers concluded that patients prefer treatments that maximize the chance of achieving meaningful itch control while minimizing the risk of AEs (cancer, respiratory infections, and heart problems).

These findings provide a basis for healthcare providers to identify and discuss treatment trade-offs with patients, which may help improve shared decision-making, the authors wrote.

The analysis was sponsored by LEO Pharma USA.

References

1. Feldman SR, Guerin A, Gauthier-Loiselle M, et al. Patient preferences for treatment attributes in moderate-to-severe atopic dermatitis: a discrete choice experiment. Poster presented at: Maui Derm Hawaii 2024; January 22-26, 2024; Wailea, Maui, HI.

2. Ervin C, Crawford R, Evans E, et al. Patient and caregiver preferences on treatment attributes for atopic dermatitis. J Dermatolog Treat. 2022;33(4):2225-2233. doi:10.1080/09546634.2021.1940810