{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T06:46:39Z","timestamp":1776753999476,"version":"3.51.2"},"reference-count":15,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,7,20]],"date-time":"2018-07-20T00:00:00Z","timestamp":1532044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although atopic dermatitis (<jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>) is a very common skin disease, data on the percentage of patients with really difficult\u2010to\u2010treat <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> are scarce. From socio\u2010economic perspective, it is important to have more insight into these numbers, as new very effective, but expensive, treatment options will be available in the near future for difficult\u2010to\u2010treat <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>. Estimating the number of patients with <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> using oral immunosuppressive drugs can give an impression of the percentage of difficult\u2010to\u2010treat patients in the total <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To give an overview of the use of oral immunosuppressive drugs in patients with <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> in the Netherlands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prescription data of oral immunosuppressive drugs in the Netherlands were extracted from a pharmaceutical database (<jats:styled-content style=\"fixed-case\">NC<\/jats:styled-content>ontrol) containing data of 557 million prescriptions and 7.2 million patients. An algorithm, based on the <jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content> Anatomical Therapeutic Chemical (<jats:styled-content style=\"fixed-case\">ATC<\/jats:styled-content>) codes, was used to identify patients with <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>. The prescription of oral immunosuppressive drugs in patients with <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> between 1 January 2012 and 1 January 2017 was evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Based on the algorithm, 65\u00a0943 patients with <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> were selected. 943 patients with <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> (1.4%) used cyclosporine A, methotrexate, azathioprine or mycophenolic acid. Methotrexate was most commonly used, followed by azathioprine and cyclosporine A. A switch in medication was rarely seen. In the evaluation period, a decrease in the prescription of cyclosporine A was seen, together with an increase in the prescription of methotrexate. In 31% of the patients who stopped treatment, the discontinuation took place within the first months of treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this study population, 1.4% of the patients with <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> used oral immunosuppressive drugs for their eczema in a 5\u2010year period. Methotrexate was the most commonly used systemic drug in the Netherlands for the treatment of <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.14896","type":"journal-article","created":{"date-parts":[[2018,2,27]],"date-time":"2018-02-27T13:16:36Z","timestamp":1519737396000},"page":"1336-1342","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Use of oral immunosuppressive drugs in the treatment of atopic dermatitis in the Netherlands"],"prefix":"10.1111","volume":"32","author":[{"given":"F.M.","family":"Garritsen","sequence":"first","affiliation":[{"name":"Department of Dermatology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.M.","family":"van den Heuvel","sequence":"additional","affiliation":[{"name":"Department of Respiratory Disease Academic Medical Center University of Amsterdam Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.A.F.M.","family":"Bruijnzeel\u2010Koomen","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.H.","family":"Maitland\u2010van der Zee","sequence":"additional","affiliation":[{"name":"Department of Respiratory Disease Academic Medical Center University of Amsterdam Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.P.H.","family":"van den Broek","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy University Medical Center Utrecht Utrecht The Netherlands"},{"name":"Department of Clinical Pharmacy St Antonius Hospital Nieuwegein The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.S.","family":"de Bruin\u2010Weller","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,7,20]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1610-0387.2008.06967_supp.x"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.07.049"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2014.03.030"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13064"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1610020"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31191-1"},{"key":"e_1_2_5_8_1","unstructured":"Prevalence of atopic dermatitis. Available onhttps:\/\/www.volksgezondheidenzorg.info\/onderwerp\/constitutioneel-eczeem\/cijfers-context\/huidige-situatie#node-prevalentie-van-constitutioneel-eczeem. Last consulted on 23\u201011\u20102017."},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.03.024"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14238"},{"key":"e_1_2_5_11_1","first-page":"802","article-title":"Long\u2010term use of systemic treatments for moderate\u2010to\u2010severe atopic dermatitis in adults: a monocentric retrospective study","volume":"96","author":"Vedie AL","year":"2016","journal-title":"Acta Derm Venereol"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2016.09.021"},{"key":"e_1_2_5_13_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1111\/ddg.12958","article-title":"Usage and effectiveness of systemic treatments in adults with severe atopic eczema: First results of the German Atopic Eczema Registry TREATgermany","volume":"15","author":"Schmitt J","year":"2017","journal-title":"J Dtsch Dermatol Ges"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.13730"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.13961"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.14398"}],"container-title":["Journal of the European Academy of Dermatology and Venereology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjdv.14896","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.14896","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T22:13:52Z","timestamp":1694988832000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdv.14896"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,20]]},"references-count":15,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2018,8]]}},"alternative-id":["10.1111\/jdv.14896"],"URL":"https:\/\/doi.org\/10.1111\/jdv.14896","archive":["Portico"],"relation":{},"ISSN":["0926-9959","1468-3083"],"issn-type":[{"value":"0926-9959","type":"print"},{"value":"1468-3083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,20]]},"assertion":[{"value":"2017-12-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-01-31","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}