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A substantial proportion of the US population has symptoms of eczema; 31.6 million with eczema, and at least 17.8 million with moderate to severe eczema or atopic dermatitis. The prevalence of childhood eczema/atopic dermatitis in the US is 10.7% overall and as high as 18.1% in individual states and 21% across various countries. Approximately one out of every three children with eczema/atopic dermatitis has moderate to severe disease. A recent study found that the prevalence of eczema in adults could be as high as 10.2%, which suggests that most children with eczema/atopic dermatitis continue to be affected even in adulthood. Three percent of US adults have moderate to severe eczema/atopic dermatitis requiring systemic therapy. These numbers are much higher than for psoriasis, a disease that now has many good-targeted treatments for moderate to severe patients. Yet, there are still very large unmet needs for the treatment of patients with eczema / atopic dermatitis.
This discrepancy between the higher prevalence and lack of good treatments for moderate to severe eczema stems, in part, from an incomplete understanding of the disease. For many years, there was an active debate whether the primary defect is in the skin barrier or an immune abnormality. Recent therapeutic developments point to a role for specific molecules in the origin or development of eczema. In particular, clinical trials with a specific immune antagonist that targets the interleukin 4 receptor, demonstrated rapid reversal of disease activity, providing evidence of its immune nature. This novel treatment represents a paradigm shift for how eczema / atopic dermatitis will be treated and opens the door to future targeted therapeutics.
Hanifin JM, Reed ML. A population-based survey of eczema prevalence in the United States. Dermatitis. 2007 Jun;18(2):82-91.
Shaw TE, Currie GP, Koudelka CW, Simpson EL. Eczema prevalence in the United States: data from the 2003 National Survey of Children’s Health. J Invest Dermatol. 2011 Jan;131(1):67-73.
Silverberg JI, Simpson EL. Association between severe eczema in children and multiple comorbid conditions and increased healthcare utilization. Pediatr Allergy Immunol. 2013 Aug;24(5):476-86.
Silverberg JI, Hanifin JM. Adult eczema prevalence and associations with asthma and other health and demographic factors: A US population-based study. J Allergy Clin Immunol. 2013 Oct 3. doi:pii: S0091-6749(13)01366-3. 10.1016/j.jaci.2013.08.031. [Epub ahead of print].