Simpson EL, et al. - Experts ascertained the patient-reported burden of adult atopic dermatitis (AD) in terms of disease severity and inadequate control in adults from clinical settings. Among patients with moderate/severe AD, inadequate disease control was common, and an association with a higher patient-reported burden was seen in these patients vs patients with controlled disease. A higher burden of moderate/severe AD was noted vs mild AD, regardless of disease control, suggesting that more effective therapies for moderate/severe disease are needed.

Methods

• Experts used data from six academic medical centers in the US collected by a self-administered internet-based questionnaire for this cross-sectional study.
• They stratified 1,519 adult patients with AD by AD severity (mild vs moderate/severe) using the Patient-Oriented Scoring Atopic Dermatitis (PO-SCORAD).
• They further stratified the patients with moderate/severe disease using systemic immunomodulators/phototherapy as having adequate or inadequate disease control.
• Validated measures and stand-alone questions assessing itch (pruritus numerical rating scale; PO-SCORAD itch visual analog scale), pain (numerical rating scale), sleep (PO-SCORAD sleep visual analog scale; sleep interference with function), anxiety and depression (Hospital Anxiety and Depression Scale), and health-related quality of life (Dermatology Life Quality Index) were included in the outcomes.

Results

• Findings suggested that among the 1,519 adult patients with AD, relative to mild AD (n=689, 64% women; mean [SD] age, 46.5 [18.0] years), more severe itching and pain, greater adverse effects on sleep, higher prevalence of anxiety and depression (417 [50.2%] vs 188 [27.3%]), and greater health-related quality-of-life impairment was reported by patients with moderate/severe AD (n=830, 66.8% women; mean [SD] age, 45.1 [16.9] years).
• Results revealed that higher burdens of itch and sleeping symptoms were demonstrated by 103 patients with moderate/severe AD with inadequate disease control, despite treatment with systemic immunomodulators or phototherapy (55.7%) vs patients with controlled disease, this includes more days per week with itchy skin (5.7 vs 2.7) and higher proportions with itch duration greater than half a day (190 [22.8%] vs 20 [2.9%]).
• As per data, trouble sleeping (3.9 vs 1.1 on the PO-SCORAD VAS), longer sleep latency (38.8 vs 21.6 minutes), more frequent sleep disturbances (2.6 vs 0.4 nights in past week), and greater need for over-the-counter sleep medications (324 [39%] vs 145 [21%]) were included as sleep symptoms.