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J Eur Acad Dermatol Venereol. 2019 Oct 6. doi: 10.1111/jdv.16003. [Epub ahead of print]

The Patient-reported Disease Burden in Adults with Atopic Dermatitis: A Cross-sectional Study in Europe and Canada.

Author information

1
University Medical Center Utrecht, Utrecht, The Netherlands.
2
Regeneron, Tarrytown, NY, USA.
3
Kantar, Health Division, Paris, France.
4
Oregon Health and Science University, Portland, OR, USA.
5
Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
6
Centre Hospitalier Universitaire de Nantes, Nantes, France.
7
Universita di Verona, Verona, Italy.
8
Probity Medical Research, Waterloo, ON, Canada.
9
St. John's Institute of Dermatology, Guy's and St, Thomas' NHS Foundation Trust and Kings College London, London, United Kingdom.
10
Hannover Medical University, Hannover, Germany.
11
Sanofi, Chilly-Mazarin, France.

Abstract

BACKGROUND:

Cross-sectional data on patient burden in adults with atopic dermatitis (AD) from real-world clinical practice are limited.

OBJECTIVE:

This study compared patient-reported burden associated with adult AD across severity levels from clinical practices in Canada and Europe.

METHODS:

This study included adults (18-65 years) diagnosed with AD by dermatologists, general practitioners, or allergists. Participants categorized as mild (n = 547; 37.3%), moderate (n = 520; 35.4%), or severe (n = 400; 27.3%) based on Investigator's Global Assessment completed a questionnaire that included pruritus and pain numerical rating scales, PO-SCORAD itch and sleep visual analog scales, Dermatology Life Quality Index (DLQI), and the Hospital Anxiety and Depression Scale (HADS). Participants were also stratified by inadequate efficacy/intolerance/contraindication to cyclosporine (Cyclo; n = 62 [4 mild, 18 moderate, 40 severe]) and any systemic immunomodulatory agent (IMM; n = 104 [13 mild, 31 moderate, 60 severe]) and compared with the severe group excluding participants identified as Cyclo/IMM.

RESULTS:

Age was similar across severity groups; the proportion of females was higher in the mild group relative to severe (61.2% vs. 50.5%; P < 0.001). Compared with moderate and mild, participants with severe AD had more comorbidities, higher itch and pain severity, worse sleep, and higher levels of anxiety and depression (all P < 0.001). Mean ± SD DLQI score among participants with severe AD (16.2 ± 6.9) showed a large effect on quality-of-life that was higher than those with moderate (10.2 ± 6.3) and mild (5.5 ± 4.9) (both P < 0.001). The burden among Cyclo and IMM subgroups was generally similar to that of participants with severe AD.

CONCLUSIONS:

Adults with AD reported a substantial burden across multiple domains that was significantly higher in those with severe disease. The burden among participants in the Cyclo/IMM subgroups was similar to those with severe AD.

KEYWORDS:

atopic dermatitis; burden; patient-reported outcomes; severity; systemic therapy

PMID:
31587373
DOI:
10.1111/jdv.16003

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