[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-409509-105":59,"doc-detail-409509-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","utilization-and-predictors-of-use-of-immunomodulators-for-atopic-dermatitis-a-cohort-study","Utilization and predictors of use of immunomodulators for atopic dermatitis - A cohort study","","Retrospective cohort analysis using US claims data from 2017 to 2023 assessed utilization of dupilumab, tralokinumab, upadacitinib, and abrocitinib in patients with atopic dermatitis. Drug initiators increased from 2,598 in 2017 to 34,646 in 2023, with prescription growth after approvals in late 2021 to early 2022. The study also evaluated baseline characteristics and identified patient-level predictors specifically associated with higher odds of dupilumab initiation.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/utilization-and-predictors-of-use-of-immunomodulators-for-atopic-dermatitis-a-cohort-study/409509/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/utilization-and-predictors-of-use-of-immunomodulators-for-atopic-dermatitis-a-cohort-study/409509.png","ImageObject",300,407,{"name":92,"@type":93},"Oliver","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",15,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What data source and study period were used to assess drug utilization?","Question",{"text":113,"@type":114},"The study used US claims data from 2017 to 2023 and identified patients with atopic dermatitis who initiated dupilumab, tralokinumab, upadacitinib, or abrocitinib.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How did overall utilization change from 2017 to 2023?",{"text":118,"@type":114},"The number of patients with at least one dispensing of the study drugs increased from 2,598 in 2017 to 34,646 in 2023, with additional increases following drug approvals in December 2021 through January 2022.",{"name":120,"@type":111,"acceptedAnswer":121},"Which factors were associated with higher odds of starting dupilumab?",{"text":122,"@type":114},"Higher odds of dupilumab initiation were associated with age 12–17, female sex, Medicaid insurance, history of allergies, pregnancy, and venous thromboembolism or anticoagulant use, compared with other study drugs.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},409509,1790868117,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":52,"preview_page_count":4},8796095461610,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Utilization and predictors of use of immunomodulators for atopic dermatitis: A cohort study  \nTo the Editor: Current US guidelines recommend dupilumab and tralokinumab as potential first-line systemic agents for atopic dermatitis (AD) in addition to topical therapies and janus kinase inhibitors (JAKi), upadacitinib, and abrocitinib, for those who failed other systemic therapies or have contradictions.1 These medications have unique side effect and monitoring profiles.2 Because the baseline risk factors for adverse events may differ among initiators of upadacitinib or abrocitinib compared with dupilumab ortralokinumab, it is important to understand how clinicians select from these treatment options for AD. Therefore, we sought to describe recent utilization and predictors of dupilumab, tralokinumab, upadacitinib, and abrocitinib use in patients with AD.  \nIn this retrospective cohort study using US claims data from 2017 to 2023, we identified patients with AD who initiated dupilumab, tralokinumab, upadacitinib, or abrocitinib. We determined the proportion of initiators who used each drug by calendar year and assessed patient characteristics in the year before start. We used least absolute shrinkage and selection operator to determine predictors of dupilumab initiation. See Appendix for detailed methods.  \nUtilization: The number of patients who had at least 1 pharmacy dispensing of the study drugs increased from 2598 in 2017 to 34,646 in 2023 (Supplementary Fig 1, [https://osf.io/vzep6/](https://osf.io/vzep6/)[ ](https://osf.io/vzep6/)[overview?view_only=635fb19708e540638c67a47ce9](overview?view_only=635fb19708e540638c67a47ce9)[ ](overview?view_only=635fb19708e540638c67a47ce9)[85c30f](85c30f)) . Although dupilumab was increasingly used before the approval of other drugs, there was a steady increase in prescriptions for tralokinumab, abrocitinib, and upadacitinib following their approval in December 2021 to January 2022 (Supplementary Fig 2, [https://osf.io/vzep6/](https://osf.io/vzep6/)[ ](https://osf.io/vzep6/)[overview?view_only](overview?view_only=635fb19708e540638c67a47ce)[=](overview?view_only=635fb19708e540638c67a47ce)[635fb19708e540638c67a47ce](overview?view_only=635fb19708e540638c67a47ce)[ ](overview?view_only=635fb19708e540638c67a47ce)[985c30f](985c30f)) .  \nPatient characteristics: There were 29,728 patients in the new-user cohort treated with dupilumab (n = 26,653, 89.7%), tralokinumab (n = 924, 3. 1%), upadacitinib (n = 1875, 6.3%) and abrocitinib (n = 276,0 .9%) (Supplementary Table I, [https://osf](https://osf). io/vzep6/overview?view_only=635fb19708e540638c6 7a47ce985c30f) . Patients who initiated tralokinumab orabrocitinib were older (mean ages 45.7 and 43.4 years,  \n© 2025 The Author(s). Published by Elsevier Inc. on behalf of the American Academy of Dermatology, Inc. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.o](http://creativecommons.o)[rg/licenses/by-nc-nd/4.0/](rg/licenses/by-nc-nd/4.0/)).  \nrespectively) compared with dupilumab and upadacitinib users (mean ages 40.0 and 40.2 years, respectively) (Table I) . About 10. 1% of dupilumab initiators used topical ruxolitinib compared with > 20% for other drugs (Supplementary Table II, [https://osf.io/vzep6/](https://osf.io/vzep6/)[ ](https://osf.io/vzep6/)[overview?view_only](overview?view_only=635fb19708e540638c67a47ce98)[=](overview?view_only=635fb19708e540638c67a47ce98)[635fb19708e540638c67a47ce98](overview?view_only=635fb19708e540638c67a47ce98)[ ](overview?view_only=635fb19708e540638c67a47ce98)[5c30f](5c30f)) . Lower proportion of dupilumab initiators had used nonbiologic system agents in the baseline (4 .9%) . There was a higher prevalence of heart disease, heart failure, or acute coronary syndrome among those treated with tralokinumab (8 .9%) . Serious infections requiring hospitalization, mental health conditions, and cytopenia were uniformly low across all drug groups.  \nPredictors of dupilumab prescription: age ","cbCaik7jmJR3mW1F","https://ap.wps.com/l/cbCaik7jmJR3mW1F","pdf",963997,"English","# Utilization\n## Trends over calendar years\n# Patient characteristics\n# Predictors of dupilumab prescription\n## Demographics and comorbidities\n## Prior medication use\n# Clinical interpretation","[{\"question\":\"What data source and study period were used to assess drug utilization?\",\"answer\":\"The study used US claims data from 2017 to 2023 and identified patients with atopic dermatitis who initiated dupilumab, tralokinumab, upadacitinib, or abrocitinib.\"},{\"question\":\"How did overall utilization change from 2017 to 2023?\",\"answer\":\"The number of patients with at least one dispensing of the study drugs increased from 2,598 in 2017 to 34,646 in 2023, with additional increases following drug approvals in December 2021 through January 2022.\"},{\"question\":\"Which factors were associated with higher odds of starting dupilumab?\",\"answer\":\"Higher odds of dupilumab initiation were associated with age 12–17, female sex, Medicaid insurance, history of allergies, pregnancy, and venous thromboembolism or anticoagulant use, compared with other study drugs.\"}]","Utilization and predictors of use of immunomodulators for atopic dermatitis - A cohort study | PDF",1790582435]