Itch and Skin Pain in Patients With AD Linked With Significant QOL Burden

The significant quality of life burden associated with symptoms of itching and/or skin pain in patients with atopic dermatitis (AD) may warrant alternate approaches to address unmet needs.

Symptoms of itching and/or skin pain in patients with atopic dermatitis (AD) were associated with significantly worse quality of life (QOL) and more dissatisfaction with condition improvement and treatment, according to study findings from Japan published recently in Current Medical Research and Opinion.

As 2 of the most common and burdensome symptoms associated with AD, itch and skin pain have both been shown in research to have considerable impacts on work productivity and QOL in patients.

Moreover, the presence of comorbidities such as sleep disturbance and mental health disorders, which are more prevalent in those with AD, may further exacerbate risk of adverse health outcomes and lead to higher health care resource utilization.

“It is known that patients with AD in Japan experience a high disease burden due to symptoms affecting sleep, QOL, and work productivity," the authors wrote, in outlining the need for the study. "However, there is limited evidence of the frequency that skin pain is experienced alongside itch and their combined impact on AD patients in Japan."

They conducted an analysis of data derived from the 2020 Adelphi AD Disease Specific Programme (DSP), a point-in-time cross-sectional survey of dermatologists (n = 56) and their patients with a history of moderate to severe AD (N = 265), to assess the incremental dual burden and impact of itch and skin pain on satisfaction, QOL, and work productivity in patients of Japan.

Data were collected between April and September 2019 and stratified by patient characteristics, including having no itch/skin pain (No I/SP, reference group, n = 89), itch/no skin pain (I-only, n = 71), and itch and skin pain (I + SP, n = 26).

QOL was evaluated using the Dermatology Life Quality Index (DLQI; range 0–30); the Patient-Oriented Eczema Measure (POEM) evaluated the presence of AD signs and symptoms in the past week, and their impact on sleep; Work Productivity and Activity Index (WPAI) evaluated AD effects on productivity during the past 7 days (range 0–100). Descriptive analyses were performed alongside a range of regression models, dependent on outcome variables.

Compared with the reference group, patients of the I + SP and I-only groups exhibited significantly worse scores for satisfaction, QOL, and work productivity:

  • patients of the I + SP group showed a 4.97-point worse POEM score (P =.005) and 14.5% more overall work impairment (P = .034)
  • patients of the I-only and I + SP groups were 8.92 and 23.5 times more likely, respectively, to experience sleep disruption on a day-to-day basis (both, P < .001)
  • patients of the I + SP were 4.6 times more likely to be bothered by their symptoms (P = .034), had a mean EASI score 6.7 points higher (P = .008), and had 1.39 more areas affected (P = .001)
  • patients of the I + SP were 7.26 times more likely to express dissatisfaction with lack of improvement in their condition and 8 times more likely to be dissatisfied with convenience of treatment (both, P < .05)

“This dissatisfaction, alongside variations in reported symptomatic burdens, suggests that physicians could consider alternative and/or novel therapeutic approaches for the management of both itch and skin pain,” concluded researchers.

Reference

Torisu-Itakura H, Anderson P, Piercy J, Pike J, Sakamotoa A, Kabashima K. Impact of itch and skin pain on quality of life in adult patients with atopic dermatitis in Japan: results from a real-world, point-in-time, survey of physicians and patients. Curr Med Res Opin. 2022 Jul 5;1-10. doi:10.1080/03007995.2022.2092352