Disease burden and treatment history among adults with atopic dermatitis receiving systemic therapy: baseline characteristics of participants on the EUROSTAD prospective observational study

Abstract

Background: Insights into the real-world treatment paradigm and long-term burden of atopic dermatitis (AD) are needed to inform clinical and health policy decisions. Methods: The prospective, observational EUROSTAD study enrolled adults with moderate-to-severe AD starting or switching systemic therapy (51 sites in 10 European countries). We report the baseline characteristics, treatment patterns, and outcomes of these patients using descriptive statistics. Results: A 12-month enrollment period of EUROSTAD was completed and 308 patients were enrolled: average age 37 years, AD duration 25 years, 43% were female. Most patients reported use of systemic therapy (93%) and !1 atopic comorbidity (82%). Mean [standard deviation] disease severity/burden measures were high: Investigator's Global Assessment (3.1 [0.8]), Eczema Area and Severity Index (16.2 [10.9]), Peak Pruritus Numerical Rating Scale (5.5 [2.5]), sleep impairment Visual Analog Scale (49.8 [31.6]) scores, and time lost from work (4.1 [13.7] days/year) or usual activities (16.8 [38.7] days/year). Most patients showed borderline or clinical levels of anxiety (59%) and/or depression (63%) using the Hospital Anxiety and Depression Scale. Conclusions: Adults with moderate-to-severe AD starting/switching systemic treatment enrolled in EUROSTAD have a high burden of longstanding disease despite continuous use of topical drugs, emollients, and systemic therapies.

Burden of Moderate to Severe Atopic Dermatitis in Adults from France, Italy, and the UK: Patient-Reported Outcomes and Treatment Patterns

“…In general, the likelihood of having a comorbidity increased with the use of systemic treatments, which might be expected since use of systemic treatments is likely to reflect patients with more severe disease. Similar to our findings, the EUROSTAD prospective observational study recently reported a high level of comorbidities, AD burden, and impact on work and daily activities [ 26 ].…”

“…With newly emerging therapies and further treatments in development [ 1 , 23 , 24 ], there is a continuous need to better understand the burden of disease and real-world treatment patterns for adults with moderate to severe AD in European countries, particularly the barriers regarding conventional (and on-label) treatments and limitations of their use. Findings from recent analyses of treatment patterns in the UK [ 25 ], Europe [ 26 ], and the USA [ 27 , 28 ] suggest a lack of disease control with established therapies and an unmet need for safe and effective targeted agents for long-term disease control [ 25 , 26 ].…”

Dupilumab Treatment of Atopic Dermatitis in Routine Clinical Care: Baseline Characteristics of Patients in the PROLEAD Prospective, Observational Study

“…Conversely, the mean (SD) DLQI scores in the present study (13.9 [7.1]) were more similar to those reported in the PsoBest registry (12.4 [3.4]) [ 21 , 22 ]. Consistently, the physician- and patient-reported severity and burden of AD in PROLEAD were also greater than those reported in the TREATgermany AD registry and prospective, observational, European-wide EUROSTAD study, as indicated by mean respective EASI (22.9 vs. 16.1 vs. 16.2, respectively), SCORAD (63.3 vs. 40.96 vs. not reported), Peak Pruritus NRS (7.4 vs. not reported vs. 5.5), DLQI (13.9 vs. 11.8 vs. 11.8), and POEM (20.4 vs. 16.8 vs. 17.0) scores [ 23 , 24 ]. Mean IGA scores in PROLEAD (3.3) were comparable to those in EUROSTAD (3.1) [ 24 ].…”

“…Consistently, the physician- and patient-reported severity and burden of AD in PROLEAD were also greater than those reported in the TREATgermany AD registry and prospective, observational, European-wide EUROSTAD study, as indicated by mean respective EASI (22.9 vs. 16.1 vs. 16.2, respectively), SCORAD (63.3 vs. 40.96 vs. not reported), Peak Pruritus NRS (7.4 vs. not reported vs. 5.5), DLQI (13.9 vs. 11.8 vs. 11.8), and POEM (20.4 vs. 16.8 vs. 17.0) scores [ 23 , 24 ]. Mean IGA scores in PROLEAD (3.3) were comparable to those in EUROSTAD (3.1) [ 24 ]. The results of the present and previous studies investigating dupilumab demonstrate the potential to improve management of moderate-to-severe AD.…”

Patient-oriented measures for phase 3 studies of tralokinumab for the treatment of atopic dermatitis (ECZTRA 1, 2, and 3)

“…Atopic dermatitis (AD) is a chronic, inflammatory skin disease. 1 Signs and symptoms, including eczematous lesions and intense itch, can be highly debilitating, 2,3 leading to significant impact on sleep, [4][5][6] mental health, 7,8 health-related quality of life (HRQoL), 2,4,[8][9][10] work productivity, 4,10 and social interactions. 2,4 In addition, this burden appears to directly correlate with increasing disease severity.…”