Patient preferences for treatment attributes in moderate-to-severe atopic dermatitis: a discrete choice experiment

Abstract

Purpose: Evidence on treatment preferences of patients with moderate-to-severe atopic dermatitis (AD) in the United States (US) is limited and an assessment of treatment preferences in this group is warranted.Materials and methods: An online discrete choice experiment survey was conducted (June 2023) among US adults with self-reported moderate-to-severe AD or experience with systemic therapy who had inadequate response to topical treatments. Preference weights estimated from conditional logistic regression models were used to calculate willingness to trade off and attributes’ relative importance (RI).Results: Participants (N = 300; mean age: 45 years; 70% females; 52% systemic therapy experienced) preferred treatments with higher efficacy, lower risk of adverse events (AEs), and less frequent blood tests (p < .05). Treatment attributes, from high to low RI, were itch control (38%), risk of cancer (23%), risk of respiratory infections (18%), risk of heart problems (11%), sustained improvement in skin appearance (5%), blood test frequency (3%), and frequency and mode of administration (2%); together, AE attributes accounted for more than half of the RI.Conclusions: Participants preferred AD treatments that maximize itch control while minimizing AE risks, whereas mode of administration had little impact on preferences. Understanding patients’ preferences may help improve shared decision-making, potentially leading to enhanced patient satisfaction with treatment, increased engagement, and better clinical outcomes.

Keywords:

• Atopic dermatitis
• patient preferences
• treatment attributes
• discrete choice experiment

Acknowledgments

Medical writing assistance was provided by professional medical writer, Flora Chik, PhD, an employee of Analysis Group, Inc., and was funded by LEO Pharma A/S, which is the manufacturer of tralokinumab.

Ethics statement

This study was approved by the Western Copernicus Group Institutional Review Board (WCG IRB) and exempt from continuing review by the Board under the revised common rule. The research met the requirements for a waiver of documentation of consent under 45 CFR §46.117(c)(1)(ii).

Author contributions

AG, MGL, NCH, YM, and KG contributed to study conception and design, collection and assembly of data, and data analysis and interpretation. SRF, AJC, and SB contributed to study conception and design, data analysis and interpretation. All authors reviewed and approved the final content of this manuscript.

Disclosure statement

SRF has received research, speaking and/or consulting support from Eli Lilly and Company, GlaxoSmithKline/Stiefel, AbbVie, Janssen, Alovtech, vTv Therapeutics, Bristol-Myers Squibb, Samsung, Pfizer, Boehringer Ingelheim, Amgen, Dermavant, Arcutis, Novartis, Novan, UCB, Helsinn, Sun Pharma, Almirall, Galderma, LEO Pharma, Mylan, Celgene, Ortho Dermatology, Menlo, Merck & Co, Qurient, Forte, Arena, Biocon, Accordant, Argenx, Sanofi, Regeneron, the National Biological Corporation, Caremark, Teladoc, BMS, Ono, Micreos, Eurofins, Informa, UpToDate and the National Psoriasis Foundation. He is founder and part owner of Causa Research and holds stock in Sensal Health; AC, and SB are employees of LEO Pharma; AG, MGL, NCH, and YM are employees of Analysis Group and have received consulting fees from LEO Pharma Inc.

Previous presentations

Part of the materials was presented at the Revolutionizing Atopic Dermatitis (RAD) Virtual Conference in May 2023 and at the 43rd Fall Clinical Dermatology Conference in October 2023.

Data availability statement

The data that support the findings of this study are available on reasonable request. The data are not publicly available and cannot be deposited into a public repository, primarily due to the fact that study participants did not consent to this. The project team was responsible for not compromising research participant privacy/consent.

Additional information

Funding

This study was funded by LEO Pharma A/S, which is the manufacturer of tralokinumab. The study sponsor was involved in several aspects of the research, including the study design, interpretation of data, writing of the manuscript, and decision to submit the manuscript for publication.