P086 The UK-Irish Atopic Eczema Systemic TherApy Register (A-STAR): baseline characteristics of the cohort
Authors: Elizaveta Gribaleva, Carlos Chivardy Moreno, Rayka Malek, David Prieto-Merino, Bolaji Coker, Lilia de la Cruz, Manisha Baden, Paula Beattie, Sara Brown, Tim Burton, Shona Cameron, Michael J Cork, Ross Hearn, John R Ingram, Alan D Irvine, Graham A Johnston, Alice Lambert, Irene Man, Louise Newell, Graham Ogg, Prakash Patel, Mandy Wan, Richard B Warren, Richard Woolf, Nick J Reynolds, Andrea Manca, Michael R Ardern-Jones, Carsten Flohr
Journal: British Journal of Dermatology (2024)

Abstract A-STAR is a prospective register of UK and Irish patients with atopic eczema receiving systemic immunomodulatory therapies. The register is designed to assess the short- and long-term clinical and cost-effectiveness and safety of such treatments in a real-world setting. We present descriptive data collected at cohort entry across 35 sites from 2018 to 13 December 2023, including patient demographics, comorbidities, past and current treatments, physician-assessed severity, patient outcomes and health resource utilization. In total 677 patients (mean age 28.9 years, SD 16.4, 44.6% female) have been recruited. Asthma, food allergies and allergic rhinoconjunctivitis were the most prevalent atopic comorbidities in the cohort (60.8%, 46.0% and 42.6%, respectively). Two-thirds (67.5%, n = 297) of patients were previously exposed to systemic treatment for atopic eczema, with on average to two (SD 1.4) systemic medications at baseline. When entering the register, patients had a mean Eczema Area and Severity Index of 20.0 (SD 12.7), Patient-Oriented Eczema Measure of 19.6 (SD 6.7), peak pruritus numerical rating scale of 6.8 (SD 2.2) and (Children’s) Dermatology Life Quality Index of 15.4 (SD 7.7). The most commonly started systemic medications at baseline were dupilumab (45.0%, n = 255), methotrexate (32.3%, n = 183) and ciclosporin (8.9%, n = 47), followed by upadacitinib (4.5%, n = 24), abrocitinib (3.5%, n = 20) and baricitinib (3.2%, n = 18). In total 44.3% (n = 297) of patients reported losing a median of 10 days (interquartile range 4–30) of usual activities due to atopic eczema in the 3 months prior to enrolment. Within 3 months before enrolment, 32% (n = 153) of patients had been treated in a day care unit, for a median of 2 days (interquartile range 1–2), while 7.7% (n = 37) had been hospitalized for their atopic eczema during the same period. As for EuroQol-5D at baseline, patients reported pain and anxiety or depression having a significant impact on their general health, with 84.7% and 68.8% of adults and 84% and 69.2% of children experiencing pain and anxiety or depression, respectively. Overall, 52.8% of adults and 59.6% of children reported atopic eczema having a negative impact on usual activities. A-STAR is a register of patients with atopic eczema receiving systemic immunomodulatory treatment. It collects data in different dimensions of treatment effectiveness, safety and health resource use. Further collection of health resource utilization data will help in devising an efficient strategy for accurate estimates for health economic modelling of atopic eczema systemic therapies. A-STAR is funded through BADERL, a registered not-for-profit company within the British Association of Dermatologists. BADERL receives income from AbbVie, Eli Lilly and Pfizer for providing pharmacovigilance services on their therapies. The A-STAR study protocol, study conduct and all decisions concerning data analyses, interpretation and publication are made independently of any industry involvement.