Higher Self-Reported Severity of AD Indicative of Lower Health-Related Quality of Life

From the patient’s perspective, higher atopic dermatitis severity is associated with poorer HRQoL — a burden that may provide motivation for more effective management of atopic dermatitis.

Patients with atopic dermatitis (AD) report lower health-related quality of life (HRQoL) with increasing levels of disease severity, a study in the British Journal of Dermatology suggests.

A total of 1232 individuals with mild AD (n=134) and moderate to severe AD (n=1098) across Europe and the United States were recruited from the National Health and Wellness Survey (NHWS). Respondents participated in a 35-minute online survey. The researchers measured current disease severity status using the Patient-Oriented SCORing of AD (PO-SCORAD) scores, with scores of <25 representing mild severity, 25 to 50 representing moderate severity, and >50 representing severe AD. Additionally, the 5-level EuroQol-5D version (EQ-5D-5L), Dermatology Life Quality Index (DLQI), and Patient-Oriented Eczema Measure (POEM) were used to measure participants’ HRQoL.

Higher reported AD severity was associated with significantly poorer HRQoL in respondents with moderate-to-severe AD (Spearman’s r=-0.38 [EQ-5D] and 0.61 [DLQI], respectively; both P <.001). The multivariable regression analysis showed that with each 0.03-point reduction in the EQ-5D score, there was an associated 5-point increase in the PO-SCORAD category (P <0.001). In addition, each 1.4-point increase in DLQI was associated with a 5-point increase in the PO-SCORAD (P <0.001). The severity of AD was also positively associated with POEM (Spearman’s r=0.51; P <.001), with each 5-point increase in PO-SCORAD severity demonstrating an associated 1.3-point increase in POEM (P <.001) in the adjusted regression analysis.

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Limitations of the study included the self-reported nature of the data, which was a result of the lack of medical chart verification for the AD diagnoses, and the use of a survey for data collection.

“In terms of AD treatment,” the researchers added, “the European population showed a more frequent immunosuppressant treatment than in the US population, which could be explained by the fact that the immunosuppressant treatment (cyclosporine) is approved for short-term treatment of severe refractory AD in many European countries but not in the US.”

Disclosure: This clinical trial was supported by AstraZeneca and LEO Pharma. Please see the original reference for a full list of authors’ disclosures.

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Andersen L, Nyeland ME, Nyberg F. Higher self-reported severity of atopic dermatitis in adults is associated with poorer self-reported health-related quality of life in France, Germany, the UK and the US [published online August 22, 2019]. Br J Dermatol. doi:10.1111/bjd.18451