Patient Experience and Preferences for Treatments in Atopic Dermatitis

Abstract

Although type 2 inflammatory pathway dysfunction is a hallmark of atopic dermatitis (AD), disease symptoms in many patients are also driven by other immune/inflammatory pathway dysfunctions, all of which lead to varied treatment response profiles of targeted systemic therapies for individual patients. Adding complexity to the process of identifying which systemic therapy to prescribe for an individual patient is that these treatments have varied safety profiles, routes of administration, monitoring requirements, and costs—all of which are reviewed during today’s shared decision-making discussions. This patient assessment study aimed to better understand patients' attitudes toward contemporary AD treatments, their experiences, and their perceptions of a molecular test to predict treatment response. A 32-question assessment tool, deemed eligible for IRB exemption, was made available to any attendees with AD at the 2024 Eczema Expo who wished to complete it. Regarding treatment objectives, results indicated the top three factors most important to respondents (n = 40) were itch control (70%), skin clearance (58%), and safety/side effects (50%). For respondents switching from their initial topical therapy due to lack of efficacy (n = 37), 38% switched to a systemic drug. Among respondents who had used targeted systemics (n = 22), 18% switched systemics, 4.5% added another systemic, 32% added topicals, and 45% did not modify their initial systemic treatment. The top two reasons for switching systemics or adding a topical treatment to their systemic were insufficient skin clearance and itch control. Of respondents open to taking a new systemic therapy, 94% showed interest in a test that would inform them about which targeted systemic therapy would work best for them. These findings highlight a clinical need for personalized therapeutic guidance in AD to improve patient care and treatment satisfaction.