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

C Elise Kleyn; Sébastien Barbarot; Catherine Reed; Serena Losi; Lill-Brith von Arx; Camille Robert; Peter Anderson; Susanne Grond; Antonio Costanzo

doi:10.1007/s13555-022-00777-z

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

Dermatol Ther (Heidelb). 2022 Aug;12(8):1947-1965. doi: 10.1007/s13555-022-00777-z. Epub 2022 Aug 1.

Authors

C Elise Kleyn¹, Sébastien Barbarot², Catherine Reed^{3

4}, Serena Losi⁵, Lill-Brith von Arx⁵, Camille Robert⁵, Peter Anderson⁶, Susanne Grond⁵, Antonio Costanzo^{7

8}

Affiliations

¹ Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester National Institute for Health Research Biomedical Research Centre, The University of Manchester, Manchester, UK.
² Service de Dermatologie, Centre Hospitalier Universitaire de Nantes, Nantes, France.
³ Eli Lilly and Company, Indianapolis, IN, USA. reed_catherine@lilly.com.
⁴ Eli Lilly and Company, 8 Arlington Square West, Downshire Way, Bracknell, Berkshire, RG12 1PU, UK. reed_catherine@lilly.com.
⁵ Eli Lilly and Company, Indianapolis, IN, USA.
⁶ Adelphi Group Products, Macclesfield, Cheshire, UK.
⁷ Dermatology, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
⁸ Dermatology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.

Abstract

Introduction: Moderate to severe atopic dermatitis (AD) is associated with a significant disease burden, impacting sleep, quality of life, and treatment needs. The aim of this study was to characterize disease burden and treatment patterns for adults with moderate to severe AD in three European countries: France, Italy, and the UK.

Methods: This retrospective analysis of adult patients with moderate to severe AD in Europe used medical records and physician/patient survey data collected in August 2019 to April 2020. Demographic and baseline disease characteristics, information on current comorbidities, disease flares, and current and previous treatments were collected by the physician. Patient-perceived burden was assessed using patient-reported outcome (PRO) questionnaires, which were completed on a voluntary basis and included the following instruments: Patient-Oriented Eczema Measure (POEM), Dermatology Life Quality Index (DLQI), EuroQol five-dimensional (EQ-5D), and Work Productivity and Activity Impairment (WPAI). Disease severity was subjectively assessed by physicians and was based on their own definition of the terms mild, moderate, and severe. Data were analyzed descriptively.

Results: The physician-reported sample included 912 patients with moderate to severe disease from France (n = 314), Italy (n = 309), and the UK (n = 289); approximately 30% of patients provided PRO data. Across these countries, 22-41% of patients reported current flares; mean POEM and DLQI scores were 10.6-13.1 and 9.5-11.1, respectively, indicating a high disease burden. However, systemic therapy use was low (e.g., conventional systemics were used by 18-24% of patients). Physician-assessed disease severity did not fully align with EASI scores, indicating that factors in addition to skin signs are impacting AD severity.

Conclusion: Patients with moderate to severe AD report significant disease burden, highlighting unmet treatment needs, particularly with respect to the underuse of systemic treatments despite AD being a systemic disease and the associated disease burden.

Keywords: Atopic dermatitis; Patient-reported outcomes; Real-world data; Treatment patterns.