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Patient burden in atopic dermatitis (AD) is significant and is comparable to other dermatoses without systemic involvement.
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Itch and pain are the most common symptoms in AD, and can have pronounced detrimental effects on quality of life (QoL) and sleep in patients with AD.
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Disease impacts include work and leisure limitations, difficulties in interpersonal relationships, and time lost to management of the disease.
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Most studies demonstrate a significant association between increasing disease
Patient Burden of Atopic Dermatitis
Section snippets
Key points
Measurement of patient burden in atopic dermatitis
Assessment of QoL is important in the management of AD as well as in clinical trials. Although QoL generally correlates with disease severity, they are not always closely related.5 This suggests that severity as assessed by clinicians does not fully capture the impact on patients. Therefore, when making therapeutic decisions, clinicians should take the QoL impact of a patient’s AD into account and not only rely on assessments of symptoms and signs. For example, a patient with mild disease based
Itch and Pain
Itch perpetuates the dermatitis cycle and is a major component of the diagnostic criteria for AD.10 In an electronic questionnaire-based study of 304 patients with AD, 91% reported daily itch and 68% experienced itch more than 4 times each day.11 Most patients who experience itch find it difficult to live with. The National Family Opinion survey in 2001 included 559 respondents with a self-reported history of AD symptoms or diagnosis.12 In this population, 63.2% of respondents rated their
Effects of treatment on quality of life in patients with atopic dermatitis
Many AD treatment studies include QoL measures, and almost all report improvement of QoL measures that parallel response to treatment.
Several large studies have evaluated the impact of topical calcineurin inhibitors on QoL. According to these studies, treatment with topical tacrolimus and pimecrolimus improves QoL in parallel with improvements in disease severity in children and adults.37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48 One of the largest of these was a postmarketing surveillance
Summary
AD creates a significant burden on patients. Knowledge of the key contributors to decreased QoL can direct clinicians to better assess burden on an individual basis. Validated tools to assess QoL can be helpful in assessing or monitoring patient burden and response to treatment, and can be incorporated relatively easily into routine clinical care, especially those that can be answered and scored quickly and simply at a patient’s appointment.8, 9 In lieu of these standardized tools, clinicians
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Cited by (30)
Efficacy and safety of dupilumab monotherapy in adults with moderate-to-severe atopic dermatitis: a pooled analysis of two phase 3 randomized trials (LIBERTY AD SOLO 1 and LIBERTY AD SOLO 2)
2019, Journal of Dermatological ScienceCitation Excerpt :Dupilumab versus placebo significantly reduced symptoms of pain/discomfort in patients who reported at least some pain/discomfort at baseline. Pain is an important symptom of AD [9,10]. In the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative), the results of a global patient survey (N = 1111) identified pain/soreness, together with itch, as the items most important to patients when judging treatment response [28].
Estimation of Health Utilities Based on the Response to Treatment in Atopic Dermatitis: a Population-based Study
2019, Clinical TherapeuticsCitation Excerpt :The definition, causes, symptoms, severity, disease progression, treatment goal, and the characteristics of atopic dermatitis in adult patients were included in the overall description. The specific description included the general symptoms,31,34,35 comorbidities such as infection, eye disease, and allergic disease,36–41 effect on sleep,31,42 effect on mental health,8,34,43 and effect on usual activities.31,34,42,44,45 Each component was described by the health status of response and no response (Table I).
The unmet medical need in management of adult patients with moderate-to-severe atopic dermatitis in Greece
2023, Archives of Hellenic Medicine
Disclosure Statement: Dr A.M. Drucker is an investigator for Sanofi and Regeneron and has received honoraria from Astellas Canada.