Treatment Patterns and Healthcare Utilization on Pediatric Atopic Dermatitis With Allergic Comorbidities: A Japanese Claims‐Based Study

Atopic dermatitis (AD) is a chronic, itchy skin disease that often begins in infancy and may persist into adulthood. The high co-occurrence of allergic comorbidities (ACMs; asthma, food allergy, and allergic rhinitis) makes it a growing public health concern. However, real-world data on treatment patterns and the economic burden of AD in children remain sparse. This retrospective observational study aimed to assess the clinical profiles of pediatric patients with AD using data from the JMDC Claims database. Children aged 0-6 years diagnosed with AD between January 2018 and September 2023 were included. A total of 244 316 children with AD (mean age: 3.1 years; 51.3% male) were included. Of these, 17.7% had AD-only, and 82.3% had AD with ACM. Allergic rhinitis was the most prevalent ACM. Topical corticosteroids were the most prescribed treatment, with 94.0% of patients with ACMs and 85.5% of those with AD-only receiving them. Potent corticosteroids were more frequently used in the AD with ACM group. Systemic steroids (31.5% vs. 4.8%) and antihistamines (95.5% vs. 56.1%) were used more often in the AD with ACMs group than in the AD-only group. Patients in the AD with ACM versus AD-only group had more outpatient visits (11.1/year vs. 6.5/year) and comparable hospitalization frequency, but shorter hospital stays (2.4 vs. 7.7 days per year). Median annual healthcare costs were substantially higher in the AD with ACM group compared to the AD-only group (139 391 Yen vs. 98 646 Yen), with costs increasing as the number of ACMs increased. Notably, 84.7% of patients with three ACMs incurred annual healthcare costs exceeding 100 000 Yen. These findings highlighted the increased clinical and economic burden associated with the increasing number of ACMs in children with AD, emphasizing the need for more intensive treatment and healthcare resources.