Comparison of real-world treatment outcomes of systemic immunomodulating therapy in atopic dermatitis patients with dark and light skin types.
Bosma AL., Ouwerkerk W., Heidema MJ., Prieto-Merino D., Ardern-Jones MR., Beattie P., Brown SJ., Ingram JR., Irvine AD., Ogg G., Patel P., Reynolds NJ., Hearn RMR., Wan M., Warren RB., Woolf RT., Hyseni AM., Gerbens LAA., Spuls PI., Flohr C., Middelkamp-Hup MA., TREAT NL registry and UK-Irish A-STAR Study Groups None.
BACKGROUND: Few data exist on differences in treatment effectiveness and safety in atopic dermatitis patients of different skin types. OBJECTIVE: To investigate treatment outcomes of dupilumab, methotrexate, and ciclosporin, and morphological phenotypes in atopic dermatitis patients, stratified by Fitzpatrick skin type. METHODS: In an observational prospective cohort study, pooling data from the Dutch TREAT (TREatment of ATopic eczema) NL (treatregister.nl) and UK-Irish A-STAR (Atopic eczema Systemic TherApy Register; astar-register.org) registries, data on morphological phenotypes and treatment outcomes were investigated. RESULTS: A total of 235 patients were included (light skin types [LST]: Fitzpatrick skin type 1-3, n = 156 [Ethnicity, White: 94.2%]; dark skin types [DST]: skin type 4-6, n = 68 [Black African/Afro-Caribbean: 25%, South-Asian: 26.5%, and Hispanics: 0%]). DST were younger (19.5 vs 29.0 years; P .05). LIMITATIONS: Unblinded, non-randomized. CONCLUSION: Atopic dermatitis differs in several characteristics between LST and DST. Skin type may influence treatment effectiveness of dupilumab.