Racial and Ethnic Disparities in Access to Advanced Therapies for Atopic Dermatitis in the United States

Atopic dermatitis (AD) is a chronic, systemic disease that impacts individuals of all ages, races, and ethnicities worldwide. It is strongly influenced by genetic, socioeconomic, and environmental factors and is associated with an increased risk of multiple comorbidities, including allergic and autoimmune conditions.¹ Despite growing interest and understanding of AD, evidence suggests that there are racial and ethnic differences in prevalence, disease severity, and treatment patterns in the United States. However, data on the distribution of comorbidities among racial and ethnic groups and their impact on management and treatment remain limited.² Additionally, non-white patients and those with comorbidities are underrepresented in clinical trials for advanced systemic therapies for AD.^3,4

Systemic therapies play a significant role in the management of moderate-to-severe AD, particularly when topical treatments are insufficient or impractical.⁵ Conventional systemic therapies include systemic corticosteroids, methotrexate, cyclosporine, mycophenolate mofetil, and azathioprine. Advanced systemic therapies, including injectable biologics and oral Janus Kinase inhibitors, are now approved and strongly recommended by the American Academy of Dermatology (AAD) guidelines for the management of AD.⁵

The objective of this study was to compare participant characteristics, disease severity and impact, comorbidities, and treatment type across racial and ethnic groups. Additionally, we sought to evaluate whether race/ethnicity was an independent predictor of advanced systemic therapy use.

This cohort study assessed treatment patterns within the TARGET-DERM AD registry and compared enrollment characteristics across established racial and ethnic categories. The registry comprises an ongoing, IRB-approved, multi-center, observational cohort of patients diagnosed with AD