背景:特应性皮炎(AD)是由2型T辅助细胞介导的对环境抗原的免疫应答引起的常见炎性疾病。约1/5的AD患者出现中度至重度疾病,食品和药物管理局批准的治疗方法包括润肤剂,局部糖皮质激素,和钙调磷酸酶抑制剂.Dupilumab,一种完全的人类单克隆抗体,通过抑制白细胞介素-4和白细胞介素-13改善AD。
目的:我们的目的是在大型大学附属卫生系统中描述成人dupilumab治疗AD的处方模式。
方法:回顾性研究,观察性队列研究使用来自观察性健康数据科学和信息学数据库的电子数据进行,评估科罗拉多大学医学院及其附属机构的数据。测量的结果是成人AD患者使用dupilumab的患病率(n=6421),2013年3月28日至2021年3月28日。我们评估了接受dupilumab的患者的特征是否与未接受的患者不同。使用单变量逻辑回归评估每个患者的特征,二元结果为接受或不接受dupilumab。
结果:我们发现AD的人群患病率为5.6%(6421/114,476)。在我们的队列中,与白人患者相比,黑人AD患者接受dupilumab的可能性是白人患者的两倍多(比值比2.352,95%CI1.58-3.39)。诊断为特应性神经性皮炎的患者接受dupilumab的可能性大约是其他AD诊断变异患者的两倍(比值比1.87,95%CI1.01-3.22)。
结论:我们的结果表明,患者种族特征和特定AD诊断均与dupilumab处方模式的变化相关。
BACKGROUND: Atopic dermatitis (AD) is a common inflammatory disease caused by a type 2 T helper cell-mediated immune response to environmental antigens. Approximately 1 in 5 patients with AD presents with moderate to severe disease, and treatments approved by the Food and Drug Administration include emollients, topical glucocorticoids, and calcineurin inhibitors. Dupilumab, a fully human monoclonal antibody, improves AD via inhibition of interleukin-4 and interleukin-13.
OBJECTIVE: Our aim was to characterize the prescribing patterns of dupilumab for AD in adults at a large university-affiliated health system.
METHODS: A retrospective, observational cohort study was conducted using electronic data from the Observational Health Data Sciences and Informatics database, assessing data from the University of Colorado Medical Campus and its affiliates. The outcome measured was the prevalence of dupilumab prescribed for adults with AD (n=6421), between March 28, 2013, and March 28, 2021. We assessed whether the characteristics of patients who received dupilumab were different from those who did not. Each patient characteristic was assessed using a univariate logistic regression with the binary outcome of receiving or not receiving dupilumab.
RESULTS: We found a population prevalence of 5.6% (6421/114,476) for AD. In our cohort, Black patients with AD were more than twice as likely to have received dupilumab compared to White patients (odds ratio 2.352, 95% CI 1.58-3.39). Patients with a diagnosis of atopic neurodermatitis were approximately twice as likely to have received dupilumab compared to those with other diagnostic variants of AD (odds ratio 1.87, 95% CI 1.01-3.22).
CONCLUSIONS: Our results demonstrate that both patient racial characteristics and specific AD diagnoses were associated with variations in dupilumab prescription patterns.