Atopic dermatitis and ocular surface disorders: a United States claims-based cross-sectional study

Background: To estimate the prevalence of ocular surface disorders (OSDs) by atopic dermatitis (AD) status and evaluate healthcare resource utilization (HRU) among patients with AD. Methods: Patients (all ages) enrolled in the Optum Clinformatics^® database were included in this two-part, retrospective, observational, cross-sectional study using administrative claims data. For objective 1, patients with/without AD who had continuous enrollment from July 1, 2018, through December 31, 2019, were included; for objective 2, patients with AD who had ≥ 18 months of continuous enrollment any time during April 1, 2016, through December 31, 2018. OSD prevalence was compared between patients with an AD diagnosis vs. those without. HRU was assessed among patients with AD and continuous enrollment for 6 months before and 12 months after AD diagnosis. Results: A total of 79,761 patients with AD and 11,313,523 without AD were included in objective 1. By AD status, OSD prevalence was higher among patients with vs. those without AD (16.9% vs. 9.5%); by age, it was highest among children aged ≤ 5 years (11.4%). The most common OSD was conjunctivitis (8.7% vs. 3.1% by AD status). Among 325,979 patients with AD in objective 2, there was a mean ± standard deviation of 0.87 ± 3.44 OSD-related claims during a 1-year period. Among those with a ≥ 1 OSD-related claim, the mean number of claims was 4.46 ± 7.05. Patients with vs. those without an OSD during the 6 months before their AD diagnosis had higher all-cause HRU during the following year, mainly pharmacy claims (30.5 ± 41.45 vs. 21.23 ± 32.66) and outpatient visits (32.41 ± 34.50 vs. 21.36 ± 28.59). Conclusions: In this US claims database study, the proportion of patients with ≥ 1 OSD-related claim was 1.8 times higher among patients with vs. without AD, with considerable OSD-related HRU. The highest rates of OSD were seen in children aged ≤ 5 years.