Understanding Topical Treatment Experiences in Patients with Moderate-to-Severe Atopic Dermatitis: Results from a US Cross-sectional Survey

Abstract

Introduction Topical therapies remain a cornerstone in the management of atopic dermatitis (AD). However, there is limited understanding of real-world usage patterns and patient experiences. This study aims to describe the burden of topical therapy in the US.

Methods The study utilized data from the Adelphi Real World 2025 Topical Experience AD Disease Specific Programme, a cross-sectional survey with elements of retrospective data collection in the United States. This analysis included patients (≥13 years) with current moderate-to-severe AD and receiving topical therapy (topical corticosteroid or topical calcineurin inhibitor). Results were stratified by type of treatment: topical only monotherapy (TM, no concomitant systemic treatment) and topical + advanced systemic (TAS, oral JAK-i or biologic). Data collected (patient and physician completed forms) were analyzed descriptively; sample size varied for each response.

Results Mean age of the 161 patients included in this analysis was 32.2 years; 55% were females. Seventy-one percentage of patients were prescribed TM and 29% TAS. Current flaring was observed in 33% TM and 30% TAS. Application frequency varied, with 15% TM, 15% TAS applying the treatment once daily; 59% TM, 38% TAS applying twice daily, and 4% TM, 5% TAS applying more than twice daily. Average time spent per application was <2 minutes for 38% TM, 41% TAS; 2–5 minutes for 45% TM, 32% TAS, and >5 minutes for 14% TM and 24% TAS. About 67% patients agreed/strongly agreed to “I don't like the way my skin feels”; 70% TM and 55% TAS found their topical medication convenient to use. Participants reported that their topical medication impacted daily activities (37% TM and 43% TAS), clothing choices (36% TM, 40% TAS) and disrupted bedtime routine or sleep (35% TM, 36% TAS). When asked about how well the topical medication helps their eczema, 39% TM and 31% TAS were satisfied and felt it offered the best control that can be realistically achieved; 40% TM and 29% TAS were satisfied but believed better control was possible. Around 3% TM and 17% TAS were not satisfied but considered it the best achievable control, while 18% TM and 24% TAS were not satisfied and believed better control could have been achieved.

Conclusion Patients reported frequent application, disruption to daily routine, interference with clothing choices, and variable satisfaction with treatment effectiveness. Some patients experienced flares while using topical treatments, regardless of the use of systemics. Physicians should consider the patient experience of using topical medications in shared decision conversations for the treatment and management of AD.