ArticleDermatology and therapy2026
Systemic Corticosteroid Exposure in Patients with Atopic Dermatitis: A US Population-Based Study.
Article in Dermatology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionClinical guidelines recommend against routine use of systemic corticosteroids in atopic dermatitis (AD) due to associated adverse effects. Real-world adherence to these guidelines is unclear.
methodsThis retrospective cohort study evaluated US healthcare claims using Optum's Clinformatics Data Mart Database. We included two cohorts: exposure and diagnosis-based cohorts. Index was defined as the date of first systemic corticosteroid use post-AD diagnosis in the exposure cohort (AD diagnosis must have occurred within 6 months preceding index) or as the date of the first AD diagnosis in the diagnosis-based cohort. Follow-up began on index and continued until end of available data, health insurance discontinuation, death, or systemic corticosteroid discontinuation (exposure cohort) or initiation (diagnosis-based cohort). Patients were aged ≥ 12 years with diagnosed AD between 2017 and 2024 and had continuous health insurance enrollment ≥ 1 year before and after index. Patients were excluded if they had other immune-mediated inflammatory diseases within the 6 months preceding index or had history of malignancy, organ transplant, or HIV/AIDS. Systemic corticosteroid exposure duration was categorized as short term (≥ 1 day to < 30 days), medium term (> 1 month to ≤ 3 months), or long term (continuous/intermittent use for > 3 months). Categorization was informed by expert recommendations and observed prescription patterns. Exposure duration and treatment patterns were assessed in the exposure cohort. Prevalence of systemic corticosteroid use within 6 months post-AD diagnosis was evaluated in the diagnosis-based cohort.
resultsThe exposure cohort included 29,994 patients; 67.7% had short-term use, 8.5% had medium-term use, and 23.9% had long-term use. Intramuscular systemic corticosteroids accounted for 20.0% of prescriptions; 80.0% received oral systemic corticosteroids. The diagnosis-based cohort included 80,647 patients; the prevalence of systemic corticosteroid use in AD was 20.0%.
conclusionsIn the USA, systemic corticosteroids remain widely prescribed. These findings highlight the critical need for broader adoption of effective corticosteroid-sparing therapies in patients with AD.
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