Itching in Atopic Dermatitis: Patient- and Physician-reported Outcomes in the German Atopic Dermatitis Registry TREATgermany

Abstract

TREATgermany is an investigator-initiated prospective disease registry. It investigates physician- and patient-reported disease severity (Eczema Area and Severity Index (EASI), objective Scoring Atopic Dermatitis (oSCORAD), Investigator Global Assessment, Patient-Oriented Eczema Measure (POEM), Patient Global Assessment (PGA)), patient-reported symptoms (itch, sleep loss, depressive symptoms), therapy courses and dermatological quality of life (DLQI) in moderate-to-severe atopic dermatitis with SCORAD > 20. 1,134 atopic dermatitis patients (mean age 41.0 ± 14.7 years, 42.5% females) were enrolled by 40 German recruiting sites (dermatological clinics and practices) between June 2016 and April 2021. The current analysis focuses on itch scores obtained with a numerical rating scale (NRS)) documented for the previous 3 days prior to baseline visit. The results show that 97.2% (1,090 of 1,121) patients experienced itch. Itch severity correlated moderately with severity of atopic dermatitis oSCORAD (rho = 0.44 (0.39–0.48)) and EASI score (rho = 0.41 (0.36–0.46)). A strong correlation was found with self-reported disease severity as PGA (rho = 0.68 (0.65–0.71)), POEM sum score (rho = 0.66 (0.63–0.69)) and dermatological quality of life impairment DLQI (rho = 0.61 (0.57–0.65)). Itch as a subjective complaint is more closely correlated with patient-reported outcomes than with objective assessments by the physician.

Itch, sleep loss, depressive symptoms, fatigue, and productivity loss in patients with moderate‐to‐severe atopic dermatitis: Analyses of TREATgermany registry data

“…Chronic itch is a disease‐defining AD symptom, contributing to sleep loss in the affected patients 9,54 . Itch (NRS/past three days) was previously reported by 97% of TREATgermany patients at baseline with 45% reporting NRS‐scores equal to or higher than 7 55,56 . The severe itching and sleep loss can lead to a reduced quality of life and lack of physical and mental recovery, which may further provoke depressive symptoms, anxiety, clinical depression, and suicidal thoughts 57–64 .…”

“…9,54 Itch (NRS/past three days) was previously reported by 97% of TREATgermany patients at baseline with 45% reporting NRS-scores equal to or higher than 7. 55,56 The severe itching and sleep loss can lead to a reduced quality of life and lack of physical and mental recovery, which may further provoke depressive symptoms, anxiety, clinical depression, and suicidal thoughts. [57][58][59][60][61][62][63][64] In particular, the interaction of these symptoms may lead to a further exacerbation.…”

Patients' perspective, quality of life and treatment goals in Hailey–Hailey disease: Lessons learned from the German National Registry

“…Up to date, there is no validated scoring system to evaluate the disease severity of patients suffering from HHD, such as the SCORAD for atopic dermatitis 8 . Therefore patients were asked to assess their disease severity using the following tools: Assessment of the subjective symptoms: pain, itch, pruritus and sleeplessness within the last 3 days, using NRS (10‐point‐scale; 0 = no itch/pain/burning/sleep disturbance; 10 = unbearable itch/pain/burning/sleep disturbance) 9,10 Assessment of disease burden by choosing from a variety of symptoms (e.g.…”

Juckreiz, Schlafstörungen, depressive Symptome, Fatigue und Einschränkungen der Arbeitsproduktivität bei Patienten mit moderater bis schwerer atopischer Dermatitis: Daten aus dem TREATgermany‐Register

“…9,54 Juckreiz (NRS/letzte drei Tage) wurde zuvor von 97% der TREATgermany-Patienten bei der Erstuntersuchung angegeben, wobei 45% NRS-Werte von 7 oder höher berichteten. 55,56 Der starke Juckreiz und die Schlafstörungen können zu einer eingeschränkten Lebensqualität und mangelnder körperlicher und geistiger Erholung führen, was wiederum depressive Symptome, Angstzustände, klinische Depressionen und Suizidgedanken hervorrufen kann. [57][58][59][60][61][62][63][64] Insbesondere das Zusammenspiel dieser Symptome kann zu einer weiteren Verschlimmerung führen.…”

“…Chronischer Juckreiz ist ein krankheitsbestimmendes AD‐Symptom, das bei den betroffenen Patienten zu Schlafstörungen führt 9,54 . Juckreiz (NRS/letzte drei Tage) wurde zuvor von 97% der TREATgermany‐Patienten bei der Erstuntersuchung angegeben, wobei 45% NRS‐Werte von 7 oder höher berichteten 55,56 . Der starke Juckreiz und die Schlafstörungen können zu einer eingeschränkten Lebensqualität und mangelnder körperlicher und geistiger Erholung führen, was wiederum depressive Symptome, Angstzustände, klinische Depressionen und Suizidgedanken hervorrufen kann 57–64 .…”