Perception and Experience of Biologic Therapy in Atopic Dermatitis: A Qualitative Focus Group Study of Physicians and Patients in Europe and Canada

Mahreen Ameen; Stephan Meller; Andreas Pinter; Neil H Shear; Angele Soria; (the BADEL Study Group)

doi:10.1007/s13555-021-00631-8

Perception and Experience of Biologic Therapy in Atopic Dermatitis: A Qualitative Focus Group Study of Physicians and Patients in Europe and Canada

Dermatol Ther (Heidelb). 2021 Dec;11(6):2159-2177. doi: 10.1007/s13555-021-00631-8. Epub 2021 Oct 26.

Authors

Mahreen Ameen¹, Stephan Meller², Andreas Pinter³, Neil H Shear⁴, Angele Soria⁵; (the BADEL Study Group)

Affiliations

¹ Royal Free London NHS Foundation Trust, Belsize Park, London, NW3 2QG, UK. m.ameen@nhs.net.
² Department of Dermatology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany.
³ Department of Dermatology, University Hospital Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
⁴ Professor Emeritus, Department of Medicine, University of Toronto, Toronto, ON, Canada.
⁵ Department of Dermatology and Allergology, Sorbonne University, Tenon Hospital, Assistance Publique Hôpitaux de Paris, 4 rue de la Chine, 75020, Paris, France.

Abstract

Introduction: The Biologics in Atopic Dermatitis: Experiences & Learnings (BADEL) project aims to improve real-life understanding of how, where, and when biologics can play a role in the treatment of atopic dermatitis (AD) from the perspective of healthcare professionals (HCPs) and patients.

Methods: Individual experiences of 24 patients with moderate-to-severe AD and who had been treated with biologic therapy (dupilumab) for ≥ 3-6 months, and 20 HCPs with a sub-specialty interest in AD were collected by means of focus groups held in Canada, Germany, France, Italy and the United Kingdom. Dupilumab was the only biologic therapy available at the time of the study.

Results: Most patients had suffered from AD for many years, particularly from itch and psychosocial issues, with AD negatively impacting all aspects of their life. They had experienced a long treatment journey and seen many dermatologists, enduring treatment delays and failures. They had been prescribed various therapies without long-term success. Biologics provided symptom improvement, offering many patients a near-normal quality of life. Side effects, especially conjunctivitis, were the greatest drawback, and there were a few issues with incomplete or unreliable efficacy. HCPs agreed that biologic therapy for AD in the majority of patients demonstrated rapid onset, good efficacy and tolerability, and are a viable option in patients who had exhausted all other treatment options. However, those patients who failed to sufficiently respond or developed intolerable adverse effects, particularly ocular symptoms, require alternative therapeutic options.

Conclusion: Biologics can provide a near-normal quality of life for many patients with AD. Patients with AD who have failed conventional therapies should be offered all such novel therapies. Education and good patient-HCP communication will enable patients to manage their disease and treatment expectations. Patients and HCPs alike eagerly await alternative targeted therapies, which will offer greater choice and flexibility.

Keywords: Atopic dermatitis; Biologic therapy; Experiences; Patients; Physicians; Qualitative study.