Understanding the Treatment Ladder for Moderate-to-Severe Atopic Dermatitis

Understanding the treatment ladder for moderate-to-severe atopic dermatitis is so helpful to those trying to ease the burden of this condition. After giving you some surprising data points about moderate-to-severe atopic dermatitis (AD), I will briefly discuss topical treatments and then focus on systemic treatments. Be sure to read my previous article “Is Atopic Dermatitis Chronic?” Also, make sure to complete the survey at the end of this blog article and then enter to win one of 10 $100 visa cards!

For today’s discussion, on eczema/atopic dermatitis, I am sponsored by Med-IQ. Med-IQ is an accredited medical education company that provides an exceptional educational experience for physicians, nurses, pharmacists, and other healthcare professionals. I am excited to work with Med-IQ on the topic of moderate-to-severe atopic eczema because so many of my readers are affected by this condition.

Surprising data about Atopic Dermatitis*

*as provided by Med-IQ

• Around 16.5 million adults in the US have atopic dermatitis (AD), a chronic form of eczema, with 6.6 million reporting moderate-to-severe symptoms
• 5% to 10% of adults have atopic dermatitis (3% of elderly); of which, approximately one-third have moderate-to-severe disease
• 57% of adults say their healthcare provider hasn’t discussed the severity of their atopic dermatitis with them
• Only about one-third of survey respondents reported that their healthcare provider asked about how much topical medication they are using
• Very few patients reported systemic therapies being discussed, even among patients with more severe AD.
  • 72% of adults with moderate-to-severe AD say their healthcare provider did not discuss systemic therapies or are unsure whether their healthcare provider did

Understanding the treatment ladder for moderate-to-severe Atopic Dermatitis

When you or a loved one has eczema/atopic dermatitis, it has been found helpful to think of the treatment journey as a therapeutic ladder based on the severity of your atopic dermatitis; you simply start on the lowest levels and then work your way up as needed (see the illustration above).

Once a patient works their way through use of basic skin care and topical therapies to no resolve, they often then move into more advanced therapies. Quickly moving up the ladder can be necessary for moderate-to-severe atopic dermatitis patients. Phototherapies can often be time-consuming and expensive. If necessary, the patient steps up again to systemic therapies.

Systemic therapies for moderate-to-severe Atopic Dermatitis

The next steps in understanding the treatment ladder for moderate-to-severe atopic dermatitis include (as noted in the illustration above):

• Nonspecific immunosuppressants, such as systemic corticosteroids. However, these can cause rebound flares and multiple adverse effects with long-term use.
• Other immunosuppressant therapies may be prescribed, but these have not been approved by the FDA for this use and may require laboratory work.
• Newer systemic agents are now available and approved by the FDA that target the underlying causes of atopic dermatitis, including the factors that cause itch and inflammation.
  • Additionally, a dupilumab injection is approved for use in patients aged 6 years and older for moderate-to-severe atopic dermatitis that is not controlled by topical therapies.
• Systemic therapies may be augmented by topical medications.

Develop an atopic dermatitis action plan

Due to the chronic nature of atopic dermatitis, an “Atopic Dermatitis Action Plan” or  “Eczema Action Plan” is recommended for patients. Why is an Action Plan important to your care?

• A written plan with your doctor outlines your care steps, triggers, irritants to avoid and steps for applying your medicines and side effects to watch for
• The plan helps you to follow your recommended managed care
• If you follow instructions carefully and your symptoms don’t improve, this helps your doctor decide next steps
• If you develop side effects from treatments, your doctor is better able to improve your treatment

Don’t be afraid to switch doctors if your Atopic Dermatitis isn’t resolving!

Psst! Don’t settle! It is okay to question your doctor and ask them for more effective options for your condition if your atopic dermatitis does not go away. Ask your current doctor for a referral if you feel they just aren’t addressing your issues OR switch providers yourself to a dermatologist. It’s also okay, to get a second opinion from another dermatologist who might specialize in Atopic Dermatitis. Remember, you are your best advocate.

Get more information:

• National Eczema Association: NationalEczema.org
• Specifically, Atopic Dermatitis: https://nationaleczema.org/eczema/types-of-eczema/atopic-dermatitis/

Take a Survey, enter for a chance to win $100 (10 Winners)

Med-IQ is conducting an anonymous survey and would appreciate your input. The survey will take less than 10 minutes to complete. Survey responses are shared only in aggregate. Your responses to these survey questions will provide Med-IQ with important information about your experiences with atopic dermatitis, which will help us develop future educational initiatives.

Once you’ve completed the survey, you will have the option of providing your email address to be entered into a drawing administered by SOMA Strategies to win 1 of 10 $100 VISA gift cards. If you choose to enter, your email address will be used only to randomly draw the winners and notify them of their prize.

All readers (whether you suffer from eczema/atopic dermatitis or not) can complete the survey, then enter to win one of 10 $100 Visa Gift Cards! (Ends February 15, 2020)

Enter Here!

Links to external sites are provided as a convenience and for informational purposes only. They are not intended and should not be  construed as legal or medical advice, nor are they endorsements of any organization. Med-IQ bears no responsibility for the accuracy, legality, or content of any external site. Contact the external site for answers to questions regarding its content.

I was compensated by Med-IQ through an educational grant from Sanofi Genzyme and Regeneron Pharmaceuticals to write about the signs, symptoms, and treatments available for atopic dermatitis or eczema. All opinions are my own.