Patients’ preferences for systemic treatment of atopic dermatitis: safety and efficacy count the most

Abstract

Background

The advent of biologics and janus kinase inhibitors has revolutionized treatment of atopic dermatitis (AD).

Objective

To investigate preferences of patients with AD for attributes of currently approved systemic treatments and assess influencing factors.

Methods

An online discrete choice experiment was conducted in patients with AD throughout Germany to analyze preferences for outcome (probability of (almost) clear skin at week 16, probability of significant itch improvement, time to onset of itch relief and type of side effects) and process attributes (application method and frequency of laboratory tests).

Results

Participants (n = 182, 75.3% female) considered side effects (Relative Importance Score (RIS): 31.2), (almost) clear skin (RIS: 24.2) and probability of itch improvement (RIS: 16.0) most important. Application method (RIS: 14.4), time to onset of itch relief (RIS: 7.4) and frequency of laboratory tests (RIS: 6.8) were less relevant. Preferences were significantly influenced by sex, age, psychiatric comorbidity, current therapy and health-related quality of life according to multivariate regression analysis.

Conclusions

Participants attached great importance to safety and symptom control. However, preferences were also dependent on individual characteristics, underscoring the importance of personal counseling. Conjoined with medical considerations, patients’ preferences have fundamental impact on shared decisions for treatment of AD.

Keywords:

• Atopic dermatitis
• biologics
• conjoint analysis
• discrete choice experiment
• janus kinase inhibitors
• preferences

Acknowledgements

The authors would like to thank all participants. For the publication fee we acknowledge financial support by Deutsche Forschungsgemeinschaft within the funding programme „Open Access Publikationskosten“ as well as by Heidelberg University.

Authors contributions

MLS, CK and WKP were involved in the conception and design of the study. DK, PW and CK performed analysis. MLS, DK, WKP, PW and CK interpretated the data. MLS, CK and WKP prepared the first draft of the paper. MLS, DK, WKP, PW and CK revised it critically for intellectual content and approved the final version to be published. All authors agree to be accountable for all aspects of the work.

Disclosure statement

M.-L. Schaarschmidt has been an advisor to and/or received speakers’ honoraria from and/or received grants from and/or participated in clinical trials by the following companies: Abbvie, Allmirall, Biogen Inc., BMS GmbH, Boehringer Ingelheim, Celgene, Eli Lilly, Janssen-Cilag GmbH, LEO Pharma, Merck Serono GmbH, MSD SHARP & DOHME GmbH, Novartis Pharma GmbH, Sanofi and UCB. W. K. Peitsch served as advisor for and/or obtained speakers’ honoraria from and/or received grants from and/or participated in clinical trials by the following companies: AbbVie, ALK-Abello, Almirall Hermal, Array Biopharma, Beiersdorf, Biotest, BMS, Boehringer Ingelheim, Celgene, Dermapharm, Dermasence, Eli Lilly, Galderma, GSK, Janssen-Cilag, L’Oreal, La Roche Posay, LEO Pharma, Medac, MSD, Novartis, Pfizer, Dr. Pfleger, Pierre Fabre, P&M Cosmetics, Roche, Sanofi, Sun Pharma and UCB Pharma. C. Kromer has been an advisor to and/or received speakers’ honoraria from and/or received grants from Janssen-Cilag, Novartis, and Boehringer Ingelheim. D. Kromer and P. Wellmann declare no conflicts of interest. The disclosed conflicts of interest have not influenced the content of this manuscript.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request. Additionally, the used model can be provided upon request.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.