title: Usage and effectiveness of systemic treatments in adults with severe atopic eczema: First results of the German Atopic Eczema Registry TREATgermany.
abstract: BACKGROUND
  The goal of clinical registries is to document the use and effectiveness of therapeutic interventions under real-life conditions. They are an indispensable prerequisite of evidence-based health care.
  
  
  METHODS
  Initiated in 2011, the German Atopic Dermatitis Registry TREATgermany is the first registry of patients with severe atopic dermatitis worldwide. Adults with severe atopic dermatitis (current/prior systemic antiinflammatory treatment and/or objective SCORAD ≥ 40) are prospectively followed over the course of 24 months. Employed treatment modalities are documented, and validated measuring tools are used to assess clinical disease severity (EASI, objective SCORAD), quality of life (DLQI), symptoms (POEM), global disease severity, as well as patient satisfaction. Herein, we describe the characteristics, therapeutic selection, and effectiveness of systemic antiinflammatory treatments of patients enrolled in the registry until October 2014.
  
  
  RESULTS
  Overall, 78 individuals (mean age 39 years, 61 % men) were enrolled at five recruitment centers. Patients frequently made use of inpatient and outpatient services. Not only was cyclosporine the most frequently administered systemic treatment, but also the most effective (EASI 50 response rate 51 %; EASI 75 response rate 34 % at 12 weeks). Azathioprine, methotrexate, oral prednisolone, mycophenolate, alitretinoin, and leflunomide were also used in some patients.
  
  
  CONCLUSIONS
  The present analysis of the German Atopic Dermatitis Registry provides important data with respect to current medical care of adults with severe atopic dermatitis in Germany. It shows the high disease burden, the benefits of current treatment options, and the need for additional effective and safe long-term treatment options.
authors.affiliation: Center for Evidence-based Health Care (ZEGV), Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany.|University Allergy Center (UAC), Carl Gustav Carus University Medical Center, TU Dresden, Dresden, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Schmitt
authors.affiliation: Department of Dermatology, Carl Gustav Carus University Medical Center, TU Dresden, Dresden, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Abraham
authors.affiliation: Center for Evidence-based Health Care (ZEGV), Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany.
authors.forename: Freya
authors.initials: F
authors.lastname: Trautmann
authors.affiliation: Center for Evidence-based Health Care (ZEGV), Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany.
authors.forename: Victoria
authors.initials: V
authors.lastname: Stephan
authors.affiliation: Department of Dermatology, Venereology, and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: Regina
authors.initials: R
authors.lastname: Fölster-Holst
authors.affiliation: Department of Dermatology, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Homey
authors.affiliation: Department of Dermatology and Allergology, University Hospital Bonn, Bonn, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bieber
authors.affiliation: Department of Dermatology and Allergology, University Hospital Bonn, Bonn, Germany.
authors.forename: Natalija
authors.initials: N
authors.lastname: Novak
authors.affiliation: Department of Dermatology, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Sticherling
authors.affiliation: Institute for Health Services Research in Dermatology and Nursing, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Augustin
authors.affiliation: Department of Dermatology, Elbe Medical Center, Buxtehude, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kleinheinz
authors.affiliation: Department of Dermatology, University Hospital Jena, Jena, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Elsner
authors.affiliation: Department of Dermatology, Venereology, and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Weidinger
authors.affiliation: Department of Dermatology, Allergology, and Venereology, Hanover Medical School, Hanover, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Werfel
mesh_terms: D000328:Adult; D000077556:Alitretinoin / Q000009:adverse effects / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077339:Leflunomide / Q000009:adverse effects / Q000627:therapeutic use; D008134:Long-Term Care; D008297:Male; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000627:therapeutic use; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use; D012042:Registries; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D000077556:Alitretinoin; D016572:Cyclosporine; D011239:Prednisolone; D000077339:Leflunomide; D009173:Mycophenolic Acid; D001379:Azathioprine; D008727:Methotrexate
keywords: atopic dermatitis; eczema; effectiveness; health services research; registry; systemic treatment