PA12 Evaluating how we manage our paediatric patients with eczema and psoriasis with systemic agents, and identifying barriers to research registry recruitment

Abstract Systemic and biologic medications are well established in their use for treating eczema and psoriasis. To collect ongoing real-world data on the efficacy and safety of these medications, national research registries exist: the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR) for psoriasis and A-STAR for eczema. It is very important that paediatric patients are recruited to registries as there is a lack of paediatric data from clinical trials. Younger patients have different immunology and comorbidities and are likely to be on medications for longer. Currently long-term benefits and risks are unknown and we need real-world efficacy and safety data to ensure effective management of this vulnerable population. At our tertiary dermatology centre we audited our paediatric population with eczema and psoriasis on systemic therapies, and assessed recruitment of eligible patients to research registries. A single assessor retrospectively screened all patients attending paediatric dermatology clinics over a 12-month period. Patients were eligible for inclusion in this study if they were < 18 years of age and currently prescribed a systemic agent for eczema or psoriasis. All guardians of patients not recruited to a research registry were contacted to explore their perspective. We identified 42 paediatric patients treated with a systemic for their eczema (n = 34) or psoriasis (n = 8), which included methotrexate (n = 20), dupilumab (n = 18), adalimumab (n = 3) and ustekinumab (n = 1). Research registry recruitment differed between patients with eczema and psoriasis, with 32% recruited to A-STAR vs. 75% recruited to BADBIR. Of those not recruited to a registry, 64% did not have information regarding registries documented in their clinic letters. On contacting guardians of patients not recruited, 10 of 12 respondents did not remember being informed about a registry, but would have been willing to take part. In conclusion, at our tertiary dermatology centre we are managing our paediatric patients with eczema and psoriasis with systemic agents, including methotrexate, dupilumab, adalimumab and ustekinumab. Over three times as many paediatric patients with eczema are being treated with systemics compared with those with psoriasis, yet we have been much more successful in recruiting patients to BADBIR compared with A-STAR. This highlights issues with the longer grace period between starting a systemic and study enrolment for BADBIR compared with A-STAR and an opportunity to increase recruitment. Failure to inform patients about research registries has also been identified as a barrier to enrolment, with feedback from patient guardian interviews overwhelmingly positive regarding willingness to enrol. Increased education and promotion of these registries is clearly paramount to increasing recruitment.