November 16, 2017

Extent and consequences of inadequate disease control among adults with a history of moderate to severe atopic dermatitis



Authors

  • Wenhui WeiPeter Anderson, Abhijit Gadkari, Stuart Blackburn, Rachel Moon, James Piercy, Shashank Shinde, Jorge Gomez, Eric Ghorayeb
  • DOI: 10.1111/1346-8138.14116  View/save citation
  • Abstract
    Since control of atopic dermatitis (AD) remains challenging but has not been adequately characterized, the objective of this study was to characterize disease control among patients with a history of moderate to severe AD.
    Data were from the 2014 Adelphi US AD Disease Specific Programme, a cross-sectional survey of physicians (n = 202) and their patients with history of moderate to severe AD (= 1064, 54% female, 75% white, mean age 40 years). Inadequately controlled AD as rated by the physician was defined as currently flaring; deteriorating/changeable AD; or physician dissatisfaction with current control. The overall inadequate control rate was 58.7% (= 625), which increased with current AD severity and was observed in 53.4% and 83.4% of patients receiving immunosuppressants and systemic corticosteroids, respectively. Relative to controls, inadequately controlled patients had poorer disease-specific quality of life, higher level of work impairment, greater itch and sleep interference with daily living (all < 0.05). Multivariate analysis showed factors significantly associated with inadequate control (all < 0.05), including Hispanic race, symptoms on the head/neck or lower limbs, itch and sleep interference with daily living. A limitation of the study was reliance on accuracy of reporting, potential selection bias and cross-sectional study design. In summary, there was a high rate and substantial impact of physician-rated inadequately controlled disease among patients with a history of moderate to severe AD, suggesting the need for more effective therapies.

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