Half of Patients With Moderate-to-Severe AD Have Inadequate Disease Control

Approximately one-half of patients with moderate-to-severe atopic dermatitis (AD) have inadequate control of their disease, according to study findings published in Journal of Drugs in Dermatology.

Researchers sought to quantify disease control in patients with moderate-to-severe AD in the United States, including those with dupilumab exposure. Participants were enrolled from electronic platforms from Kantar Profiles and Global Perspectives, and data were collected between February 22, 2021, and May 28, 2021.

Adults with physician-diagnosed AD were eligible to complete the primary survey regarding disease severity, clinical-trial participation, current and past treatments, and self-assessment of disease control. Among participants who self-reported moderate or severe disease, a subset was eligible to complete a second, enriched survey regarding treatment satisfaction, satisfaction with AD control, comorbidities, and other factors. Outcome measures included a number of validated patient-reported outcomes.

Among 3285 participants who completed the primary survey, 1931 had moderate or severe AD, including 266 currently using dupilumab, 49 who had previously received dupilumab but discontinued, and 1616 who had never received dupilumab. Of the patients with moderate-to-severe AD, 979 reported inadequate disease control. Current systemic corticosteroid receipt was reported by 209 participants.

The final enriched cohort included 371 participants — 87 with controlled AD and 284 with inadequately controlled AD. The mean age in the inadequately controlled AD group was 48.7 years (37.7% women) compared with 50.0 years (36.8% women) in the controlled group. Of the patients with inadequately controlled AD, 178 had never been treated with dupilumab, 83 were currently receiving it, and 23 had previously received it vs 35, 35, and 17, respectively, in the adequately controlled group.

Mean Recap of Atopic Eczema, Patient-Oriented SCORing Atopic Dermatitis, and Dermatology Life Quality Index scores were 13.9, 38.3, and 9.9 in the inadequately controlled group, respectively. Mean Treatment Satisfaction Questionnaire for Medication (TSQM-9) scores for effectiveness, convenience, and global satisfaction were 45.5, 62.3, and 48.3, respectively, compared with 69.5, 72.5, and 69.3 in the controlled group.

Participants in the inadequately controlled group had significantly worse scores (P <.01) on all AD measures, TSQM-9, and EuroQol-5D vs the controlled group. The inadequately controlled group also had worse mean anxiety, depression, and work impairment scores compared with those in the controlled group.

Limitations of the study include the use of self-reported data, which may be subject to recollection or misclassification biases. Also, the primary question on AD control was not independently validated, and participants were recruited from opt-in panels that focus on health care and general population panels.

“These results suggest a need for additional education on current and new therapies that could allow patients to achieve better AD control, improve quality of life, and greater overall treatment satisfaction,” the researchers conclude.

Disclosure: This study was supported by LEO Pharma Inc. Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.