"Part of it may also be related to the definition used in this study," he adds. To reduce the risk of potential misclassification, researchers combined self- or caregiver reporting of a doctor's diagnosis of eczema or skin allergy with the extensively validated ISAAC criteria for AD.
"Atopic dermatitis impacts all aspects of adolescent health," says Dr. Silverberg. According to a separate poster,2 increasing disease severity correlated with increasing mean scores for itch, sleep, skin pain (all captured via a 0-10 numerical rating scale/NRS) and health-related quality-of-life (HRQOL).
The centrality of itch in AD has long been recognized, says Dr. Silverberg. "But we saw similar patterns for the intensity of sleep disturbances where patients with severe AD had NRS sleep of 7.1, which is considered to be severe sleep disturbance."
EPI-CARE is one of the first studies to examine skin pain in the adolescent population, Dr. Silverberg adds. NRS scores for skin pain in patients with severe, moderate and mild AD were 7.5, 5.3 and 2.9, respectively (P<0.01 in all analyses).
"The real take-home comes down to the impact on quality of life. The more severe the atopic dermatitis, the more likely patients were to have substantial impact across all the different items and subdomains of the Children's Dermatology Life Quality Index (CDLQI)," says Dr. Silverberg. Similarly, the proportions of respondents in the severe, moderate and mild categories who reported having at least one atopic comorbidity were 81%, 68.6% and 64.3%, respectively.
"In addition, there is a substantial impact on productivity for adolescents," he notes.
Dr. Silverberg has received honoraria as a speaker/consultant for Galderma, Abbvie, AnaptysBio, Asana BioSciences, Arena, Boehringer-Ingelheim, Dermavant, Eli Lilly, GlaxoSmithKline, Glenmark, Kiniksa, Leo, Menlo, Novartis, Pfizer, and Regeneron-Sanofi and has received grants as an investigator from Galderma and GlaxoSmithKline.
1. Silverberg JI, Barbarot S, Simpson EL, et al. Epidemiology of atopic dermatitis in the adolescent population: a cross-sectional study in the United States and Europe. Poster P1458. European Academy of Dermatology and Venereology Congress; October 9-13, 2019. Madrid, Spain.
2. Weidinger S, Simpson EL, Silverberg JI, et al. The patient-reported disease burden in adolescents with atopic dermatitis: a cross-sectional study in the United States and Europe. Poster P1459. European Academy of Dermatology and Venereology Congress; October 9-13, 2019. Madrid, Spain.
3. Girolomoni G, Gadkari A, Auziere S, et al. Characterizing the patient-reported disease burden in adults with atopic dermatitis: a cross-sectional study from clinical practices in Europe and Canada. Poster P0253. European Academy of Dermatology and Venereology Congress; September 12-16, 2018. Paris, France.