Real-World Treatment Patterns in Patients with Atopic Dermatitis Initiating Ruxolitinib Cream: A 12-Month Follow-Up Analysis of a US Payer Claims Database

Purpose: This study describes a cohort of US commercially insured and Medicare Advantage patients with atopic dermatitis (AD) using ruxolitinib cream therapy and characterizes their treatment patterns before ruxolitinib cream initiation and during a 12-month follow-up. Patients and Methods: This retrospective, observational cohort study analyzed longitudinal administrative claims and social drivers of health data for patients diagnosed with AD and treated with ruxolitinib cream. Patient characteristics, treatment patterns, and healthcare resource utilization were described for the 6 months before and 12 months after ruxolitinib cream initiation. Results: The overall population (N=556) had a mean (SD) age of 40.3 (17.3) years and was 60.8% female, with 71.9% of patients being in the upper 2 socioeconomic status index score quartiles. Baseline predominant treatment patterns (overall cohort) included no treatment (26.6%), topical corticosteroids (53.4%), biologics (22.5%), systemic corticosteroids (20.9%), topical calcineurin inhibitors (14.9%), and topical phosphodiesterase-4 inhibitors (6.7%). Post-index treatment patterns showed a decreasing trend in corticosteroid use, with topical corticosteroid use dropping from 31.3% in months 1-6 to 26.6% in months 7-12, and systemic corticosteroid use stabilizing after an initial decrease (16.0% to 16.6%). However, the mean cumulative prednisone-equivalent dose among patients using systemic corticosteroids decreased overall by 28.9%, from 402.1 mg at baseline to 362.3 mg during months 1-6 and to 285.7 mg during months 7-12 of follow-up. Among the biologic-naïve cohort (n=431), 90.0% remained biologic-free during follow-up, and among the biologic-experienced cohort (n=125), 14.4% discontinued biologics during follow-up. The percentage of patients with healthcare encounters for AD decreased from 85.3% at baseline to 70.0% during follow-up. Conclusion: The reduced use of other AD treatments, including corticosteroids, and the high proportion of patients remaining biologic-free during the 12-month follow-up support the durability of the effectiveness of ruxolitinib as a therapeutic option for adults and adolescents with AD.