Research output: Contribution to journal › Article › Academic › peer-review
Comparison of real-world treatment outcomes of systemic immunomodulating therapy in atopic dermatitis patients with dark and light skin types. / TREAT NL registry and UK-Irish A-STAR Study Groups.
In: JAAD International, Vol. 10, 01.03.2023, p. 14-24.Research output: Contribution to journal › Article › Academic › peer-review
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TY - JOUR
T1 - Comparison of real-world treatment outcomes of systemic immunomodulating therapy in atopic dermatitis patients with dark and light skin types
AU - Bosma, Angela L.
AU - Ouwerkerk, Wouter
AU - Heidema, Madeline J.
AU - Prieto-Merino, David
AU - Ardern-Jones, Michael R.
AU - Beattie, Paula
AU - Brown, Sara J.
AU - Ingram, John R.
AU - Irvine, Alan D.
AU - Ogg, Graham
AU - Patel, Prakash
AU - Reynolds, Nick J.
AU - Hearn, R. M. Ross
AU - Wan, Mandy
AU - Warren, Richard B.
AU - TREAT NL registry and UK-Irish A-STAR Study Groups
AU - Woolf, Richard T.
AU - Hyseni, Ariënna M.
AU - Gerbens, Louise A. A.
AU - Spuls, Phyllis I.
AU - Flohr, Carsten
AU - Middelkamp-Hup, Maritza A.
N1 - Funding Information: The authors would like to acknowledge Manja Bloem for her support in preparing the data for analysis. NJR is a National Institute for Health and Care Research (NIHR) Senior Investigator and by the NIHR Newcastle Biomedical Research Center. RBW is supported by the Manchester NIHR Biomedical Research Centre . Publisher Copyright: © 2022 American Academy of Dermatology, Inc.
PY - 2023/3/1
Y1 - 2023/3/1
N2 - Background: Few data exist on differences in treatment effectiveness and safety in atopic dermatitis patients of different skin types. Objective: To investigate treatment outcomes of dupilumab, methotrexate, and ciclosporin, and morphological phenotypes in atopic dermatitis patients, stratified by Fitzpatrick skin type. Methods: In an observational prospective cohort study, pooling data from the Dutch TREAT (TREatment of ATopic eczema) NL (treatregister.nl) and UK-Irish A-STAR (Atopic eczema Systemic TherApy Register; astar-register.org) registries, data on morphological phenotypes and treatment outcomes were investigated. Results: A total of 235 patients were included (light skin types [LST]: Fitzpatrick skin type 1-3, n = 156 [Ethnicity, White: 94.2%]; dark skin types [DST]: skin type 4-6, n = 68 [Black African/Afro-Caribbean: 25%, South-Asian: 26.5%, and Hispanics: 0%]). DST were younger (19.5 vs 29.0 years; P < .001), more often had follicular eczema (22.1% vs 2.6%; P < .001), higher baseline Eczema Area and Severity Index (EASI) scores (20.1 vs 14.9; P = .009), less allergic contact dermatitis (30.9% vs 47.4%; P = .03), and less previous phototherapy use (39.7% vs 59.0%; P = .008). When comparing DST and LST corrected for covariates including baseline EASI, DST showed greater mean EASI reduction between baseline and 6 months with only dupilumab (16.7 vs 9.7; adjusted P = .032). No differences were found for adverse events for any treatments (P > .05). Limitations: Unblinded, non-randomized. Conclusion: Atopic dermatitis differs in several characteristics between LST and DST. Skin type may influence treatment effectiveness of dupilumab.
AB - Background: Few data exist on differences in treatment effectiveness and safety in atopic dermatitis patients of different skin types. Objective: To investigate treatment outcomes of dupilumab, methotrexate, and ciclosporin, and morphological phenotypes in atopic dermatitis patients, stratified by Fitzpatrick skin type. Methods: In an observational prospective cohort study, pooling data from the Dutch TREAT (TREatment of ATopic eczema) NL (treatregister.nl) and UK-Irish A-STAR (Atopic eczema Systemic TherApy Register; astar-register.org) registries, data on morphological phenotypes and treatment outcomes were investigated. Results: A total of 235 patients were included (light skin types [LST]: Fitzpatrick skin type 1-3, n = 156 [Ethnicity, White: 94.2%]; dark skin types [DST]: skin type 4-6, n = 68 [Black African/Afro-Caribbean: 25%, South-Asian: 26.5%, and Hispanics: 0%]). DST were younger (19.5 vs 29.0 years; P < .001), more often had follicular eczema (22.1% vs 2.6%; P < .001), higher baseline Eczema Area and Severity Index (EASI) scores (20.1 vs 14.9; P = .009), less allergic contact dermatitis (30.9% vs 47.4%; P = .03), and less previous phototherapy use (39.7% vs 59.0%; P = .008). When comparing DST and LST corrected for covariates including baseline EASI, DST showed greater mean EASI reduction between baseline and 6 months with only dupilumab (16.7 vs 9.7; adjusted P = .032). No differences were found for adverse events for any treatments (P > .05). Limitations: Unblinded, non-randomized. Conclusion: Atopic dermatitis differs in several characteristics between LST and DST. Skin type may influence treatment effectiveness of dupilumab.
KW - atopic dermatitis
KW - atopic eczema
KW - ciclosporin
KW - daily practice
KW - dupilumab
KW - effectiveness
KW - ethnicity
KW - methotrexate
KW - morphology
KW - race
KW - registry
KW - routine clinical care
KW - safety
KW - skin type
KW - systemic treatment
UR - http://www.scopus.com/inward/record.url?scp=85141779007&partnerID=8YFLogxK
U2 - 10.1016/j.jdin.2022.09.006
DO - 10.1016/j.jdin.2022.09.006
M3 - Article
C2 - 36387062
VL - 10
SP - 14
EP - 24
JO - JAAD International
JF - JAAD International
SN - 2666-3287
ER -
ID: 27505332