Clinical, Cosmetic and Investigational Dermatology (Feb 2021)

Use of Systemic Medications for Treating Adult Atopic Dermatitis in France: Results of a Practice Survey

  • Fougerousse AC,
  • Jacobzone C,
  • Mery-Bossard L,
  • Reguiai Z,
  • Droitcourt C,
  • Taieb C,
  • Maccari F

Journal volume & issue
Vol. Volume 14
pp. 179 – 183

Abstract

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Anne-Claire Fougerousse,1 Caroline Jacobzone,2 Laure Mery-Bossard,3 Ziad Reguiai,4 Catherine Droitcourt,5 Charles Taieb,6 François Maccari7 On behalf of GEM ResoEczema Group1Dermatology Department, Hôpital d’Instruction des Armées Bégin, Saint Mandé, Val de Marne, France; 2Dermatology Department, Hôpital du Scroff, Groupe Hospitalier Bretagne Sud, Lorient, Morbihan, France; 3Dermatology Department, Centre Hospitalier Intercommunal Poissy Saint Germain en Laye, Saint-Germain-en-Laye, Yvelines, France; 4Dermatology Department, Polyclinique Courlancy, Reims, Marne, France; 5Dermatology Department, Centre Hospitalier Universitaire, Rennes, Ille et Vilaine, France; 6Emma Clinic, Fontenay-sous-Bois, Val de Marne, France; 7Private Practice, Saint-Maur-des-Fossés, Val de Marne, FranceCorrespondence: Anne-Claire FougerousseDermatology Department, Hôpital d’Instruction des Armées Bégin, Saint Mandé, Val de Marne, FranceEmail [email protected]: Recent studies have illustrated that systemic medications are underused for treating adult atopic dermatitis (AD) and that dermatologists have concerns regarding the safety profile of cyclosporine in AD.Patients and Methods: We performed a national online practice survey between March and April 2020.Results: A total of 305 dermatologists responded, 57% with hospital-based activity and 43% with private practice. Overall, 46.9% prescribed cyclosporine for adult AD. Before initiating treatment, 56.9% did not perform evaluation scoring. Reasons for not prescribing cyclosporine were no eligible patients (24.7%), lack of information (52.6%), need for hospital prescription (31.2%), and lack of experience (79.2%). Fifty-four percent of the dermatologists prescribed methotrexate for adult AD. Before initiating treatment, 50.5% did not perform evaluation scoring. Reasons for not prescribing methotrexate were no eligible patients (46.7%), lack of information (39.3%), lack of experience (25.2%), and not approved for AD (47.4%). A total of 2.1% dermatologists prescribed other systemic treatments for adult AD, 9.8% prescribed corticosteroids and 56.4% prescribed dupilumab.Conclusion: Systemic treatments for AD are used by half of dermatologists, although cyclosporine and dupilumab must be initiated in hospitals in France. Methotrexate is more frequently used than cyclosporine, although it is not approved for this indication in France. A vast majority of dermatologists do not perform any evaluation scoring before initiating systemic treatment for adult AD.Keywords: atopic dermatitis, cyclosporine, methotrexate, practice survey

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