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An overview of prescribing practices in Europe for light therapy and systemic therapy in adults with moderate‐to‐severe atopic eczema
Publication year - 2020
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.19584
Subject(s) - medicine , systemic therapy , dermatology , atopic dermatitis , disease , pediatrics , cancer , breast cancer
Atopic eczema (AE) is a disease that causes redness and itch on the skin. It affects 1‐5% of adults in Europe. For many years dermatologists have had access to few therapies for patients with moderate‐to‐severe AE. New, promising therapies are entering the market but conventional light and systemic (medications that work throughout the whole body) treatments have more well‐known side‐effect profiles, lower costs and wider availability. However, good, long‐term evidence is missing and we therefore believe it is important to gather more information for these conventional treatments. With this study we wanted to show how dermatologists prescribe conventional light and systemic treatments for adults with moderate to severe AE and show which factors influence these decisions. Dermatologists were invited to participate in an online survey. We collected data on characteristics of the dermatologists and patients, data on the frequency of use of the treatments, 1 st , 2 nd and 3 th choices, reasons for and against prescribing, and dosages and discontinuation regimens used. From 30 European countries, 238 dermatologists participated. For light treatments (prescribed by 84.7%), most (80.9%) preferred narrow‐band ultraviolet‐B (a specific form of light treatment) as first choice and psoralen and ultraviolet‐A (another form of light treatment) as second (21.6%). For systemic treatments (prescribed by 95.2%), ciclosporin (54.1%), oral corticosteroids (32.6%) and methotrexate (30.7%) were used as first choice. Dermatologists mostly relied on personal experience. Azathioprine and mycophenolate acid were prescribed by only 135 (59%) and 85 (37.1%) dermatologists, mostly due to a lack of personal experience. This study shows what preferences dermatologists in Europe have and how they prescribe light and systemic treatments. It also shows that treatments not officially registered for AE are frequently prescribed and are even frequently selected as first choice of therapy. This study was performed by researchers from Denmark, Germany, Ireland, The Netherlands and the U.K. Linked Article: Vermeulen et al. Br J Dermatol 2020; 183 :1073–1082.