Clinical Scorecard: Analysis of Health Claims Data for German Patients with Atopic Dermatitis Not Adequately Managed by Standard Systemic Treatments

At a Glance

Key Highlights

• 1-year administrative prevalence of AD in Germany estimated at 2.4%, highest in ages 0–4 years
• AD-related infections, prolonged topical treatment use, and frequent active flares indicate insufficient disease control
• Conventional systemic therapies have limitations, especially for long-term use and pediatric patients

Guideline-Based Recommendations

Diagnosis

• Identify AD via documented hospital diagnosis or two outpatient diagnoses in different quarters using ICD-10-GM codes L20.8 or L20.9
• Ensure continuous insurance coverage for accurate longitudinal assessment

Management

• First-line treatment with topical agents; systemic therapies reserved for severe or insufficiently controlled AD
• Use conventional systemic agents (oral glucocorticoids, cyclosporine) cautiously due to limitations and contraindications
• Consider biologics and Janus kinase inhibitors approved by EMA for moderate-to-severe AD
• Avoid long-term oral glucocorticoids in adults; restrict use in children and adolescents to rare cases
• Use cyclosporine as interval therapy with caution, especially in patients under 16 years

Monitoring & Follow-up

• Monitor for AD-related infections as indicators of insufficient disease control
• Track prolonged topical treatment use and frequency of active flares
• Assess systemic therapy effectiveness regularly to identify insufficient disease control

Risks

• Long-term use of oral glucocorticoids carries risks and is not recommended
• Cyclosporine has limitations for long-term use and pediatric safety concerns
• New systemic agents may have limited pediatric indications or recent approvals

Patient & Prescribing Data

Patients with AD treated with conventional systemic therapies in Germany, including children aged ≥2 years

Conventional systemic therapies are commonly used but often indicate insufficient disease control; infections and flares are frequent despite treatment

Clinical Best Practices

• Use claims data and ICD-10-GM coding to identify and monitor AD patient populations
• Prioritize topical therapies and reserve systemic treatments for severe or refractory cases
• Regularly evaluate disease control indicators such as infections and flare frequency
• Consider newer biologics and Janus kinase inhibitors where appropriate and approved
• Limit long-term use of oral glucocorticoids and cyclosporine, especially in pediatric patients

References

• European Medicines Agency approvals for systemic AD treatments
• InGef Research Database Information
• German ICD-10-GM Codes for Atopic Dermatitis