A real-world study of the longitudinal course of skin pain in adult atopic dermatitis

Hong, Mindy; Lei, Donald; Yousaf, Muhammad; Chavda, Rajeev; Gabriel, Sylvie; Silverberg, Jonathan I.

doi:10.1016/j.jaad.2021.04.021

Cited by 7 publications

(3 citation statements)

References 5 publications

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“…Our analysis indicates an apparent, albeit modest, correlation between itch improvement and skin pain improvement. This is consistent with other studies, which also showed modest correlation between skin pain and itch [6,31]. Additionally, the presentation of pain in AD is highly variable among adults and adolescents [2,6,10].…”

Section: Discussionsupporting

confidence: 92%

“…Therefore, the proportion of patients with a ≥4-point improvement from baseline on the skin pain NRS item of the PSAAD was assessed in those who had a score of ≥4 at baseline. Patients with AD report suffering from persistent skin pain even when under treatment for AD due to the severity of their AD [30,31], suggesting that the minimal clinically important difference of a 4-point improvement from baseline may still leave some patients with burdensome skin pain. From a patient's perspective, itch and pain are the two most important factors when assessing treatment response [14].…”

Section: Efficacy Assessmentsmentioning

confidence: 99%

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Abrocitinib Provides Rapid and Sustained Improvement in Skin Pain and Is Associated with Improved Quality of Life Outcomes in Adult and Adolescent Patients with Moderate-to-Severe Atopic Dermatitis

Thyssen,

Bewley,

Ständer

et al. 2023

Dermatology

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Background: Skin pain in atopic dermatitis (AD) increases with disease severity and is associated with substantial quality of life (QoL) burden. Objectives: To evaluate abrocitinib efficacy on skin pain and QoL in adults and adolescents with moderate-to-severe AD. Methods: This post hoc analysis included data with abrocitinib administered as monotherapy (pooled phase 2b [NCT02780167] and phase 3 JADE MONO-1 [NCT03349060] and MONO-2 [NCT03575871]) or in combination with topical therapy (phase 3 JADE COMPARE [NCT03720470] and JADE TEEN [NCT03796676]). Patients received oral, once-daily abrocitinib 200 mg, abrocitinib 100 mg, or placebo for 12 or 16 weeks (JADE COMPARE). Skin pain was rated using the Pruritus and Symptoms Assessment for Atopic Dermatitis (PSAAD) skin pain Numerical Rating Scale (NRS) item (“How painful was your skin over the past 24 hours?”) on a scale from 0 (not painful) to 10 (extremely painful). Itch (Peak Pruritus NRS) and QoL (Dermatology Life Quality Index or Children’s Dermatology Life Quality Index) were assessed. Least squares mean (LSM) change from baseline was analyzed using mixed effects repeated measures modeling. Results: A total of 1822 patients (monotherapy pool, n=942; JADE COMPARE, n=595; JADE TEEN; n=285) were analyzed. LSM change from baseline in PSAAD skin pain score was significantly greater with abrocitinib versus placebo from week 2 through week 12 or 16 across all 3 study populations and occurred in a dose-dependent manner. A greater proportion of patients achieved a ≥4-point improvement from baseline in PSAAD skin pain score with abrocitinib (200 mg and 100 mg) versus placebo in the monotherapy pool (56% and 38% vs 12%; week 12), JADE COMPARE (72% and 52% vs 26%; week 16), and JADE TEEN (51% and 60% vs 31%; week 12). Additionally, a greater proportion of patients achieved a stringent threshold of skin pain improvement (PSAAD skin pain score <2) with abrocitinib versus placebo. Adults and adolescents who achieved a ≥4-point improvement in skin pain reported greater QoL improvement than those who did not achieve a ≥4-point improvement. A positive correlation (≥0.3) was observed between skin pain and QoL and separately between skin pain and itch across the 3 study populations. Conclusion: Abrocitinib as monotherapy or in combination with topical therapy improved skin pain and was associated with improved QoL in both adults and adolescents with moderate-to-severe AD across all evaluated studies.

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Section: Discussionsupporting

confidence: 92%

Section: Efficacy Assessmentsmentioning

confidence: 99%

Abrocitinib Provides Rapid and Sustained Improvement in Skin Pain and Is Associated with Improved Quality of Life Outcomes in Adult and Adolescent Patients with Moderate-to-Severe Atopic Dermatitis

Thyssen,

Bewley,

Ständer

et al. 2023

Dermatology

Self Cite

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“…Skin pain (which is described by patients using terms such as discomfort or soreness) is an important symptom in AD which until recently was not widely recognized by dermatologists or treatment guidelines [7], despite being one of the most frequently reported symptoms of AD after itch [8]. Skin pain can be linked to the severity of AD and itching [9], but it may also be experienced independent of itch and the itch-scratch cycle [10,11]. There is evidence to suggest that skin pain is a distinct symptom in AD.…”

Section: Introductionmentioning

confidence: 99%

Baricitinib Rapidly Improves Skin Pain Resulting in Improved Quality of Life for Patients with Atopic Dermatitis: Analyses from BREEZE-AD1, 2, and 7

Thyssen

Buhl

Fernández‐Peñas

et al. 2021

Dermatol Ther (Heidelb)

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Introduction: Skin pain (described as discomfort or soreness) is increasingly recognized as a symptom of atopic dermatitis which impacts patient quality of life. This analysis examined the effect of baricitinib on skin pain in atopic dermatitis in three phase 3 studies (BREEZE-AD1, -AD2, and -AD7). Methods: Patients were randomly assigned 2:1:1:1 to receive once-daily placebo, baricitinib 1 mg, 2 mg, or 4 mg in BREEZE-AD1 (N = 624) and -AD2 (N = 615) and 1:1:1 to receive oncedaily placebo, baricitinib 2 mg, or 4 mg, with topical corticosteroids, in BREEZE-AD7 (N = 329) for 16 weeks. Patients recorded their skin pain severity using the Skin Pain Numerical Rating Scale (NRS) via an electronic daily diary. Data were analyzed by study as least squares mean change from baseline in daily scores for the randomly assigned patients using mixed model repeated measures analysis. Analysis of

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Characteristics, mechanism, and management of pain in atopic dermatitis: A literature review

Dong

2021

Clinical & Translational All

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Background Atopic dermatitis (AD) is a chronic, pruritic, immune‐mediated inflammatory disease. Developments in basic science and clinical research have increased our understanding of AD. Although pain as a symptom of AD is underemphasized in previous studies, multiple researchers address pain as a frequent burden of AD. However, the exact role of pain in AD is not fully understood. Aims Our review aimed to summarize the current evidence focusing on characteristics, mechanism, and management of pain in AD. Materials & Methods We conducted a thorough literature review in the PubMed database to figure out different aspects discussing pain in AD, including pain symptoms, burden, the relationship between pain and itch, mechanism, and pain management in AD. Results and Conclusion AD patients affected by skin pain vary from 42.7%‐92.2% with remarkable intensity and heavy burden. Skin pain and itch interacted both in symptoms and mechanisms. Atopic skin with the impaired barrier, neurogenic inflammation mediators, peripheral and central sensitization of pain may possibly explain pain mechanism in AD. Future research is needed to clarify the commonality and disparity of pain and itch in AD in order to seek efficacious medications and treatment.

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A real-world study of the longitudinal course of skin pain in adult atopic dermatitis

Cited by 7 publications

References 5 publications

Abrocitinib Provides Rapid and Sustained Improvement in Skin Pain and Is Associated with Improved Quality of Life Outcomes in Adult and Adolescent Patients with Moderate-to-Severe Atopic Dermatitis

Abrocitinib Provides Rapid and Sustained Improvement in Skin Pain and Is Associated with Improved Quality of Life Outcomes in Adult and Adolescent Patients with Moderate-to-Severe Atopic Dermatitis

Baricitinib Rapidly Improves Skin Pain Resulting in Improved Quality of Life for Patients with Atopic Dermatitis: Analyses from BREEZE-AD1, 2, and 7

Characteristics, mechanism, and management of pain in atopic dermatitis: A literature review

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