P126 Treatment journey in patients with atopic dermatitis on abrocitinib: real-world evidence from the DREAM TO TREAT AD (D2T AD) Consortium
David Prieto-Merino, Elizaveta Gribaleva, Thomas Birkner, Niels Steen Krogh, Bolaji Coker, Ahmet Akkoc, Axel Hertzschuch, Merel C Postema, Benoit Raymond, Anne Grete Frostrup, Lara Cutlar, Louise A A Gerbens, Alan D Irvine, Maria Oberländer Christensen, Wouter Ouwerkerk, Phyllis I Spuls, Simon Francis Thomsen, Stephan Weidinger, Thomas Werfel, Jochen Schmitt, Carsten FlohrAbstract
There is a lack of real-world evidence on systemic treatment patterns in moderate-to-severe atopic dermatitis (AD). D2T AD is a European register-based study evaluating the use of abrocitinib in routine clinical care in Denmark, Germany, the Netherlands, Belgium and the UK. The aim of this study was to describe the systemic treatment journey of patients with AD prior to abrocitinib initiation. Prospectively collected data from A-STAR (UK), SCRATCH Denmark, TREATgermany and TREAT-NL/BE (the Netherlands and Belgium) registers from patients receiving abrocitinib were harmonized. Patient characteristics and treatment patterns were summarized using descriptive statistics. In total, 261 patients treated with abrocitinib were included (Denmark 50, Germany 89; the Netherlands and Belgium 72, UK 50). The mean (SD) age varied from 31.0 (15.7) in the UK to 40.3 (13.7) in Germany. There was significant heterogeneity in exposure to systemic treatments prior to abrocitinib initiation between Germany and other countries: 36% of patients in Germany were systemic naive, compared with 7% in TREAT-NL/BE, 2% in the UK and 0% in Denmark. In Germany, abrocitinib was most commonly used as a second-line treatment, and in Denmark, TREAT-NL/BE and the UK as fourth-line therapy. The most commonly used systemic medications directly prior to abrocitinib were dupilumab (50%) and upadacitinib (19%) in Germany; dupilumab (42%), baricitinib (12%) and methotrexate (12%) in the UK; dupilumab (28%) and upadacitinib (27%) in TREAT-NL/BE; and dupilumab (44%) and baricitinib (38%) in Denmark. The higher start dose of abrocitinib (200 mg) was prescribed more frequently in Denmark (90%), Germany (71%) and the UK (60%), while the lower dose was more predominant in TREAT-NL/BE (54%). The average reduction in Eczema Area and Severity Index per month ranged from −4.6 in GER and UK, to −3.5 in TREAT-NL/BE, to −3 in Denmark. There is significant variability in treatment journeys before abrocitinib initiation across European registers, which is likely to impact the observed differences in treatment effectiveness.