TY - JOUR
T1 - International survey of treatment practices for atopic dermatitis in pregnant and breastfeeding women
T2 - Physician perspectives
AU - Pereira, Manuel P
AU - Stevanovic, Katarina
AU - Kocatürk, Emek
AU - Meesch, Cathrin
AU - van Hofman, Ingrid
AU - Vaswani, Prema S
AU - Bernstein, Jonathan A
AU - Bruscky, Dayanne
AU - Chong-Neto, Herberto J
AU - Chu, Chia-Yu
AU - Criado, Roberta Fachini Jardim
AU - Ensina, Luis Felipe
AU - Giménez-Arnau, Ana M
AU - Godse, Kiran
AU - Gotua, Maia
AU - Gregoriou, Stamatios
AU - Kulthanan, Kanokvalai
AU - Mortz, Charlotte G
AU - Mitrevska, Natasa Teovska
AU - Özkaya, Esen
AU - Pudasaini, Prajwal
AU - Felix, Mara Morelo Rocha
AU - Pérez, Catalina Rincón
AU - Parisi, Claudio Alberto Salvador
AU - Ramón, Gonzalo N
AU - Vakirlis, Efstratios
AU - Zhao, Zuotao
AU - Beck, Lisa A
AU - de Bruin-Weller, Marjolein
AU - Cork, Michael
AU - Katoh, Norito
AU - Werfel, Thomas
AU - Worm, Margitta
AU - Wollenberg, Andreas
AU - Zuberbier, Torsten
N1 - Publisher Copyright:
© 2025 The Author(s). Journal der Deutschen Dermatologischen Gesellschaft published by John Wiley & Sons Ltd on behalf of Deutsche Dermatologische Gesellschaft.
PY - 2025/9
Y1 - 2025/9
N2 - BACKGROUND AND OBJECTIVES: Systemic treatment of pregnant/breastfeeding atopic dermatitis (AD) patients is challenging due to limited safety data. We explored treatment practices with systemic agents, including the guideline-recommended cyclosporine as the first systemic choice as well as emerging therapies, in this vulnerable population.PATIENTS AND METHODS: The Global Allergy and Asthma Excellence Network (GA2LEN) ADCARE initiative collected data from physicians worldwide who treat pregnant women with AD. Physicians completed an electronic questionnaire on the use of systemic agents in pregnant/breastfeeding AD patients.RESULTS: 103 physicians from 32 countries completed the survey, primarily dermatologists (n = 48) or allergologists (n = 43). Antihistamines were the systemic drug most often considered to be used during pregnancy/breastfeeding (n = 73/81, 90.1%), with fewer physicians considering the use of systemic agents for the first trimester compared to later stages of pregnancy. For acute flares, systemic corticosteroids (n = 34/80, 42.5%) were preferred, followed by biologics and antihistamines (each n = 15/80, 18.8%). Although the guideline-recommended cyclosporine is sometimes considered for AD during pregnancy (n = 38/81, 46.9%), it was rarely considered as the preferred drug by physicians (n = 1/80, 1.25%).CONCLUSIONS: Our study shows a misalignment between guideline recommendations and prescription patterns and highlights an unmet need for knowing and using the existing recommendations.
AB - BACKGROUND AND OBJECTIVES: Systemic treatment of pregnant/breastfeeding atopic dermatitis (AD) patients is challenging due to limited safety data. We explored treatment practices with systemic agents, including the guideline-recommended cyclosporine as the first systemic choice as well as emerging therapies, in this vulnerable population.PATIENTS AND METHODS: The Global Allergy and Asthma Excellence Network (GA2LEN) ADCARE initiative collected data from physicians worldwide who treat pregnant women with AD. Physicians completed an electronic questionnaire on the use of systemic agents in pregnant/breastfeeding AD patients.RESULTS: 103 physicians from 32 countries completed the survey, primarily dermatologists (n = 48) or allergologists (n = 43). Antihistamines were the systemic drug most often considered to be used during pregnancy/breastfeeding (n = 73/81, 90.1%), with fewer physicians considering the use of systemic agents for the first trimester compared to later stages of pregnancy. For acute flares, systemic corticosteroids (n = 34/80, 42.5%) were preferred, followed by biologics and antihistamines (each n = 15/80, 18.8%). Although the guideline-recommended cyclosporine is sometimes considered for AD during pregnancy (n = 38/81, 46.9%), it was rarely considered as the preferred drug by physicians (n = 1/80, 1.25%).CONCLUSIONS: Our study shows a misalignment between guideline recommendations and prescription patterns and highlights an unmet need for knowing and using the existing recommendations.
KW - Atopic dermatitis
KW - breastfeeding
KW - pregnancy
KW - survey
KW - systemic treatment
UR - https://www.scopus.com/pages/publications/105007907087
U2 - 10.1111/ddg.15728
DO - 10.1111/ddg.15728
M3 - Article
C2 - 40484810
SN - 1610-0379
VL - 23
SP - 1116
EP - 1124
JO - JDDG - Journal of the German Society of Dermatology
JF - JDDG - Journal of the German Society of Dermatology
IS - 9
ER -