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Comparing prescribing patterns for topical corticosteroids based on their FDA indication by age
Author(s) -
Freeze Megan E.,
Balogh Esther A.,
Cline Abigail,
Feldman Steven R.,
Fleischer Alan B.
Publication year - 2020
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.14442
Subject(s) - medicine , medical prescription , atopic dermatitis , ambulatory , off label use , population , pediatrics , dermatology , surgery , pharmacology , environmental health
Background/Objectives Atopic dermatitis (AD) affects up to 20% of the pediatric population, with a growing prevalence over the past 30 years. Topical corticosteroids (TCS) are commonly used as a first‐line topical therapy for AD and are prescribed in 59% of all AD visits. However, some topical corticosteroids are prescribed outside of their age range indications. This paper aims to explore the frequency with which topical corticosteroids are prescribed for AD outside of their FDA‐approved age range. Methods Data on prescribing patterns for AD were obtained from the National Ambulatory Medical Care Survey (NAMCS). We assessed the frequency of off‐label use of topical corticosteroids with respect to age indications in four specific age‐groups, as delineated in the data (0‐1, 2‐7, 8‐18, and 19+ years). Results All prescribed topical corticosteroids found in the NAMCS database have an indication for AD or other inflammatory dermatoses or pruritic dermatoses. However, some medications were prescribed outside of their FDA‐approved age indications. These off‐label prescription rates ranged from 52% for desoximetasone to 0% for halobetasol and alclometasone, or rates lower than could be detected by our study. Conclusions Much like other medications for AD treatment, TCS are sometimes used off‐label. The off‐label use of topical corticosteroids to treat pediatric AD highlights a gap between clinical practice and regulating guidelines. Additional pediatric studies would offer a greater body of evidence to maintain or expand label indications for the use of TCS in younger patients.