Preferences in atopic dermatitis: A systematic review

Background: Numerous new treatments for atopic dermatitis (AD) have been approved in recent years, but it is unknown whether published patient, caregiver and healthcare provider preferences are biased by industry funding. Objectives: To investigate funding sources and their putative influence on patients, caregivers and healthcare providers' reported preferences with regard to different properties of therapies and treatment outcomes of AD. Methods: This descriptive systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines. PubMed and EMBASE were searched. Studies were included if they reported data on AD patients', caregivers' and/or healthcare providers' preferences of therapy and/or treatment outcomes. Results: A total of 8346 studies were identified, and 42 were included for data synthesis (participants, 19,839; females, 62.2%). Nineteen and twenty-three studies were pharma-sponsored and non-pharma-sponsored, respectively. The pharma-sponsored studies were of recent dates, had larger patient populations and included discrete choice experiments. Efficacy was of great importance to patients, caregivers and healthcare providers, and this finding was mainly driven by pharma-sponsored studies. Moreover, patients were more willing to accept the risk of side effects or adverse events to achieve other treatment goals in pharma-sponsored studies. Studies sponsored by companies producing Janus kinase inhibitors showed that patients preferred the least invasive administration route despite increased administration frequency. Studies evaluating preferred topical treatment attributes were often non-pharma-sponsored. Conclusions: The findings of this study indicate that preference research may be biased. Therefore, healthcare providers should be cautious when employing treatment needs and preferences research to support decision-making.