Unmet Needs of Effective Advanced Systemic Therapies in Moderate-to-Severe Atopic Dermatitis Patients in the TARGET-DERM AD Registry

Authors

Dawn Z. Eichenfield, From the Departments of Dermatology and Pediatrics, University of California San Diego, San Diego, California, USA.
Keith D. Knapp, Target RWE, Durham, North Carolina, USA.
Ami Claxton, LEO Pharma, Madison, New Jersey, USA.
Breda Munoz, Target RWE, Durham, North Carolina, USA.
Julie M. Crawford, Target RWE, Durham, North Carolina, USA.
Sanjeev Balu, LEO Pharma, Madison, New Jersey, USA.
Yestle Kim, LEO Pharma, Madison, New Jersey, USA.
Shannon Schneider, LEO Pharma, Madison, New Jersey, USA.
Michael A. Haft, From the Departments of Dermatology and Pediatrics, University of California San Diego, San Diego, California, USA.
Jonathan I. Silverberg, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Diamant Thaci, Comprehensive Center for Inflammation Medicine, University of Lubeck, Lubeck, Germany.
Lawrence F. Eichenfield, From the Departments of Dermatology and Pediatrics, University of California San Diego, San Diego, California, USA.
Jerry Bagel, Eczema Treatment Center of New Jersey, East Windsor, New Jersey, USA.
Jamie W. Rhoads, Department of Dermatology, University of Utah Health Hospitals and Clinics, Murry, Utah, USA.
Amy S. Paller, Departments of Dermatology and Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

Document Type

Journal Article

Publication Date

2-19-2025

Journal

Dermatitis : contact, atopic, occupational, drug

DOI

10.1089/derm.2024.0191

Keywords

adolescents; adults; advanced therapy; atopic dermatitis; dupilumab; moderate-to-severe; real world data; unmet needs; upadacitinib

Abstract

In the United States, 40-50% of patients with atopic dermatitis (AD) have moderate-to-severe disease, often necessitating advanced systemic therapies (ASTs; biologics or Janus kinase inhibitors). TARGET-DERM AD is an observational, longitudinal registry that tracks the natural history and treatment of AD, including patients with moderate-to-severe disease. Among enrollees, we defined 4 patient subgroups: AST-Naïve, AST-Retrospective (AST initiated prior to enrollment), AST-Prospective (AST initiated at or after enrollment), and AST-Failed (failed at any point). This analysis describes AST-patient demographics, treatment patterns, and longitudinal outcomes. Of 598 qualifying participants (22% adolescent, 78% adult), 34% were AST-Naive, 27% AST-Retrospective, 31% AST-Prospective, and 8% AST-Failed. Comparing the adult subgroups showed significant differences in enrollment age, and race/ethnicity, but not among adolescents. There was no significant difference in AST prescription rates. Literature-based validated thresholds were used to define unchanged or worsening for each outcome, which was combined into a single category, "lacked improvement." At 52 weeks of AST, AST-Prospective adolescents lacked improvement on Validated Investigator's Global Assessment of Atopic Dermatitis (vIGA-AD) (26%), body surface area (BSA) (34%), Numeric Rating Scale (NRS)-Pain (63%), and NRS-Sleep (52%); AST-Prospective adults lacked improvement on vIGA-AD (21%), BSA (51%), NRS-Pain (66%), and NRS-Sleep (60%). As one-third of participants did not progress to AST, and noteworthy proportions of patients lacked improvement, this study highlights unmet needs and treatment inadequacies in patients with moderate-to-severe AD.

APA Citation

Eichenfield, Dawn Z.; Knapp, Keith D.; Claxton, Ami; Munoz, Breda; Crawford, Julie M.; Balu, Sanjeev; Kim, Yestle; Schneider, Shannon; Haft, Michael A.; Silverberg, Jonathan I.; Thaci, Diamant; Eichenfield, Lawrence F.; Bagel, Jerry; Rhoads, Jamie W.; and Paller, Amy S., "Unmet Needs of Effective Advanced Systemic Therapies in Moderate-to-Severe Atopic Dermatitis Patients in the TARGET-DERM AD Registry" (2025). GW Authored Works. Paper 6553.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/6553

Department

Dermatology