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      Characteristics of Atopic Dermatitis Patients Treated with Crisaborole: Real-World Data from a Large Healthcare Provider Database in Israel

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          Abstract

          Background

          In recent years, new treatments dedicated to atopic dermatitis (AD) have become available in Israel, including crisaborole, a small molecule with unique benzoxaborole chemistry.

          Objective

          To describe baseline characteristics, history of AD therapies, and use of health-care services of early crisaborole users in real-world settings.

          Methods

          A retrospective cohort study was performed using the data of a large health provider in Israel. AD patients treated with crisaborole since it became commercially available in Israel in July 2019 through end of Sep 2020, were included. Baseline demographics and clinical characteristics, prior AD-related treatments and healthcare resource utilization were collected.

          Results

          A total of 441 patients were included (57.8% females, median age = 21.1y; interquartile range = 10.5–40.8). In 62.1%, a dermatologist prescribed the first dispensed crisaborole. Median time from AD diagnosis to crisaborole treatment was 6.6 years. Up to 12 months prior to crisaborole treatment, low-, mid- and high-potency TCS were used by 30.8%, 31.1% and 55.8% of patients, respectively. Treatments related to moderate-to-severe AD were dispensed to 38.5% of patients in the prior 5 years. Asthma and allergic rhinitis were documented among 22.2% and 37.2%, respectively. In the past year, patients had a median of 9 visits to primary care physicians, 84.6% visited a dermatologist (≥5 visits: 12.9%).

          Conclusion

          While crisaborole is indicated for mild-to-moderate disease, results suggest that a significant proportion of patients had history of advanced AD therapies suggestive of moderate-to-severe AD.

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          Most cited references15

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          Atopic Dermatitis: Global Epidemiology and Risk Factors

          Atopic dermatitis (AD) is a chronic inflammatory skin disease posing a significant burden on health-care resources and patients' quality of life. It is a complex disease with a wide spectrum of clinical presentations and combinations of symptoms. AD affects up to 20% of children and up to 3% of adults; recent data show that its prevalence is still increasing, especially in low-income countries. First manifestations of AD usually appear early in life and often precede other allergic diseases such as asthma or allergic rhinitis. Individuals affected by AD usually have genetically determined risk factors affecting the skin barrier function or the immune system. However, genetic mutations alone might not be enough to cause clinical manifestations of AD, and it is merely the interaction of a dysfunctional epidermal barrier in genetically predisposed individuals with harmful effects of environmental agents which leads to the development of the disease. AD has been described as an allergic skin disease, but today, the contribution of allergic reactions to the initiation of AD is challenged, and it is proposed that allergy is rather a consequence of AD in subjects with a concomitant underlying atopic constitution. Treatment at best achieves symptom control rather than cure; there is thus a strong need to identify alternatives for disease prevention.
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            Efficacy and safety of crisaborole ointment, a novel, nonsteroidal phosphodiesterase 4 (PDE4) inhibitor for the topical treatment of atopic dermatitis (AD) in children and adults.

            Additional topical treatments for atopic dermatitis (AD) are needed that provide relief while minimizing risks.
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              Prevalence and Incidence of Atopic Dermatitis: A Systematic Review

              The primary objective of this study was to systematically review and analyse epidemiological studies of the prevalence and incidence of atopic dermatitis (AD) during childhood and adulthood, focusing on data from the 21 st century. A systematic search of PubMed, EMBASE and Google (manual search) was performed in June 2019, followed by data abstraction and study quality assessment (Newcastle–Ottawa Scale). Cross-sectional and longitudinal epidemiological studies of individuals with AD (doctor-diagnosed or standardized definition) were included. Of 7,207 references reviewed, 378 moderate/good-quality studies were included: 352 on prevalence of AD and 26 on incidence of AD. In the 21 st century, the 1-year prevalence of doctor-diagnosed AD ranged from 1.2% in Asia to 17.1% in Europe in adults, and 0.96% to 22.6% in children in Asia. The 1-year incidence ranged from 10.2 (95% confidence interval (95% CI) 9.9– 10.6) in Italy to 95.6 (95% CI 93.4–97.9) per 1,000 person-years in children in Scotland. There were few recent studies on incidence of AD in the 21 st century and no studies on adults only; most studies were conducted in Europe and the USA. Epidemiological studies on childhood and adulthood AD in different continents are still needed, especially on the incidence of AD during adulthood.
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                Author and article information

                Journal
                Clin Cosmet Investig Dermatol
                Clin Cosmet Investig Dermatol
                ccid
                Clinical, Cosmetic and Investigational Dermatology
                Dove
                1178-7015
                30 June 2022
                2022
                : 15
                : 1205-1211
                Affiliations
                [1 ]Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services , Tel Aviv, Israel
                [2 ]Pfizer Israel , Herzliya Pituah, Israel
                [3 ]Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
                [4 ]Dermatology Department, Emek Medical Center , Afula, Israel
                [5 ]Bruce and Ruth Rappaport Faculty of Medicine, Technion , Haifa, Israel
                Author notes
                Correspondence: Gabriel Chodick, Maccabitech Institute for Research and Innovation, Maccabi Healthcare , Keufmann 4 St, Tel Aviv, 68125, Israel, Tel +972-514-3755, Email hodik_g@mac.org.il
                [*]

                These authors contributed equally to this work

                Article
                359625
                10.2147/CCID.S359625
                9252191
                f71d7867-c11f-4a86-8cec-0d53f71f8c3f
                © 2022 Weil et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 07 February 2022
                : 17 May 2022
                Page count
                Figures: 2, Tables: 7, References: 15, Pages: 7
                Categories
                Original Research

                Dermatology
                atopic dermatitis,topical calcineurin inhibitors,real-world data
                Dermatology
                atopic dermatitis, topical calcineurin inhibitors, real-world data

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