Atopic dermatitis is a chronic inflammatory skin disease that affects 15% to 20% of children and 1% to 3% of adults worldwide.¹ Omalizumab, a medication administered by subcutaneous injection every 2 to 4 weeks, was approved for moderate-to-severe persistent asthma in patients aged 6 years or older by the US Food and Drug Administration in 2003.² Atopic dermatitis in children is often IgE mediated, and omalizumab is an anti-IgE medication that binds to human IgE and thus limits mast cell degranulation and inhibits the release of inflammatory mediators. Therefore, it makes logical sense that omalizumab could be efficacious in atopic dermatitis treatment.³ In this issue of JAMA Pediatrics, Chan et al⁴ conducted a 24-week double-blind, placebo-controlled randomized clinical trial to determine if omalizumab is effective in severe childhood atopic dermatitis. Their results suggested improved atopic dermatitis severity, as measured by the SCORAD (Scoring Atopic Dermatitis) index, and improved quality-of-life scores in the omalizumab group compared with the placebo group.⁴ Although the study by Chan et al⁴ suggested that omalizumab is efficacious for atopic dermatitis in children, more questions need to be answered before the drug can be used to treat atopic dermatitis in clinical practice. Specifically, this study questions whether omalizumab is cost-effective for atopic dermatitis. Cost-effectiveness analyses can help health care decision-makers choose between new and existing interventions as well as compare costs, benefits, and harms associated with each intervention.⁵ Although no cost-effectiveness analyses on omalizumab as a treatment for atopic dermatitis have been published to date, thinking through the associated costs, benefits, and harms can add perspective to the Chan et al study.⁴

特应性皮炎是一种慢性炎症性皮肤病，影响全世界15％至20％的儿童和1％至3％的成年人。¹ 2003年，美国食品药品监督管理局批准了Omalizumab（每2至4周通过皮下注射给药的药物）用于6岁或6岁以上患者的中至重度持续性哮喘^。2儿童特应性皮炎通常为IgE omalizumab是一种抗IgE药物，可与人IgE结合，从而限制肥大细胞脱粒并抑制炎症介质的释放。因此，奥马珠单抗在特应性皮炎治疗中可能是有效的，这在逻辑上是有道理的。³ Chan等在本期《美国医学会杂志》（JAMA Pediatrics）中发表文章⁴进行了一项为期24周的双盲，安慰剂对照的随机临床试验，以确定omalizumab在严重的儿童期特应性皮炎中是否有效。他们的研究结果表明，与安慰剂组相比，奥卡珠单抗组的SCORAD（得分性特应性皮炎）指数改善了特应性皮炎的严重程度，生活质量评分也得到了改善。⁴尽管Chan等人的研究⁴提示奥马珠单抗对儿童特应性皮炎有效，在临床实践中该药物可用于治疗特应性皮炎之前，还需要回答更多的问题。具体来说，这项研究质疑奥马珠单抗对于特应性皮炎是否具有成本效益。成本效益分析可以帮助医疗保健决策者在新的和现有的干预措施之间进行选择，以及比较与每种干预措施相关的成本，收益和危害。⁵尽管迄今为止尚未发表有关奥马珠单抗作为特应性皮炎治疗方法的成本效益分析，但仔细考虑相关的成本，收益和危害可以为Chan等人的研究增色。⁴