Burden, Control, and Treatment of Moderate to Severe Atopic Dermatitis in 2021: A United States Patient Survey Study

Abstract

Background: Recent data on unmet needs in the treatment of moderate to severe atopic dermatitis (AD) in the US are not available. Objective: To describe disease control, quality of life (QoL), and treatment satisfaction in a United States population with moderate-to-severe AD. Methods: Cross-sectional 2021 survey conducted among US patients recruited to an online survey from Kantar e-profiles, their panel partners, and Global Perspectives. Adults with self-reported, physician-diagnosed AD completed the primary survey. Of those reporting moderate to severe AD, a subset, including patients who “strongly disagreed,” “somewhat disagreed,” or were “neutral” on the statement “my eczema is adequately controlled” (“inadequately controlled”) with varying experience with approved biologic treatment (dupilumab), completed a second, enriched survey. Outcome measures evaluated included self-reported disease control and severity and validated measures including Patient-Oriented Scoring Atopic Dermatitis (PO-SCORAD), Dermatology Life Quality Index (DLQI), Recap of Atopic Eczema (RECAP), and Treatment Satisfaction Questionnaire for Medication (TSQM-9). Results: reported and 284 inadequatelyOf inadequate 3,285 patients control. controlledwho A total patientsparticipated of 371 (178/284 completed in theinadequatelyprimary the PenaltiesDo enriched survey, Notcontrolled1,935 Copy survey, Applyself-reportedpatients leading never to an moderate-to-severereceived analytic sample dupilumab with AD23 87 979previously controlled (51%) ofreceived patients whom it, and 83 were currently receiving it). Mean RECAP, PO-SCORAD, and DLQI scores were significantly worse (P<0.01) for inadequately controlled vs controlled patients: 7.26 vs 13.9; 38.3 vs 26.9; and 9.9 vs 7.0, respectively. MeanTSQM-9 scores for inadequately controlled vs controlled patients were significantly worse across all domains—effectiveness, convenience, and global satisfaction (P<0.01): 45.5 vs 69.5, 62.3 vs 72.5, 48.3 vs 69.3, respectively. Conclusions and Relevance: This study found about half of the patients had inadequate control of their disease. This may partially be due to underuse of systemic biologics in eligible patients. There remains an unmet need for additional education on current and new systemic biologics that could allow patients to achieve better AD control, improved QoL, and greater overall treatment satisfaction.