Managing AD Symptoms Strongly Associated with Disease Burden

Aaron M. Drucker, PhD

In addition to the severity of atopic dermatitis (AD), a recent survey study indicated that the time spent managing symptoms of AD showed the strongest associations with disease burden among affected patients.

The recent analysis, which was led by Aaron M. Drucker, MD, of the University of Toronto, was conducted to gauge the multidimensional burden of AD in order to establish more effective treatment strategies for patients.

Depsite various studies detailing the visible burden of AD, and its effect of patients’ sleep patterns, Drucker and colleagues cited significant “knowledge gaps” regarding the skin disease.

“Gaps include a poor understanding of symptoms other than itch, patients’ treatment experience, and how different elements of burden of disease interact,” they wrote.

With these gaps in mind, the team conducted an online survey of people with AD, which functioned as a part of a patient-focused drug development meeting with the US Food and Drug Administration, to better understand the implications of the condition on quality of life and treatment preferences.

The 32-item electronic survey included in the study was a collaborative effort that featured insights from patient advocacy groups, social media, and clinical experts. It would be administered to eligible patients between August 1, 2019, and October 11, 2019.

Demographic and clinical variables were considered for each patient, the latter of which included the severity of their disease and the time spent managing AD.

Respondents were tasked with defining the overall impact of the disease over the past month and the specific elements of disease burden, which were ranked on a 1-5 scale, with 5 being the most significant. Questions regarding mood changes at the worst instance of AD were also recorded on a 4-point ordinal scale.

The 1065 respondents featured in the study spanned several generations, though the highest volume of people were aged 51-64 years (27%). A majority of the respondents were women (n=881, 83%) and reported having current moderate (45%) or severe (28%) AD.

Additionally, a majority (80%) reported severe AD when theur skin condition was at its worst.

Survey Responses

Only 3% of all respondents said AD provided “no impact” on their lives, while 194 (18%) reported a low impact score, 295 (28%) reported a moderate impact score, 228 (21%) reported a high impact score, and 316 (30%) reported a significant impact on life.

A multivariable proportional odds model indicated that current AD severity was “strongly associated” with higher overall scores, and moderate (4.13,95% CI, 2.94- 5.79) and severe AD (OR, 13.63, 95% CI, 8.65-21.5) were associated with the greatest disease burden.

Likewise, patients who reported spending 11 or more hours a week tending to their AD had a greater disease burden when compared to those who responded with 0-4 hours.

A significant number of respondents reported mood changes, many of whom considered them to be “mild” in nature (40%). Current disease severity was strongly associated with mood changes in affected patients.

The findings were deemed consistent with previous reports by Drucker and colleagues, and the team noted that not 1 particular element was identified as strongly associated with overall AD disease burden. However, time spent managing AD was strongly associated with disease burden and associated mood changes.

“This suggests a need for more effective therapies that improve symptoms and reduce the time spent managing AD,” the team wrote.