Children with atopic dermatitis face ‘multidimensional’ disease burden
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PHOENIX — Young children with atopic dermatitis demonstrated a significant disease burden impacting their quality of life, according to a study presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting.
“PEDISTAD, or the Pediatric Study in Atopic Dermatitis, is an ongoing, global 5-year observational registry describing the disease characteristics, atopic comorbidities and treatment patterns in pediatric patients,” Amy S. Paller, MD, principal investigator at Northwestern University’s Skin Disease Research Center, said during the presentation.
The study recruited 732 children (mean age, 6.2 years; 52.2% boys; 65.2% white; median age at disease onset, 0.7 years) aged 12 years and younger at baseline between September 2018 and July 2020 with investigator-assessed moderate to severe atopic dermatitis.
These children were receiving systemic treatment including phototherapy or were on topical treatment but otherwise candidates for systemic treatment due to inadequate disease control and/or safety concerns associated with long-term topical treatment.
“The majority of children, or 59%, had at least one type 2 comorbidity at baseline,” said Paller, who also is the Walter J. Hamlin professor and chair of dermatology at Northwestern University Feinberg School of Medicine and a pediatric dermatologist at Ann and Robert H. Lurie Children’s Hospital of Chicago.
The most common comorbidities included allergic rhinitis (n = 251; 34.3%), food allergy (n = 242; 33.1%), asthma (n = 205; 28%) and allergic conjunctivitis (n = 93; 12.7%). Anxiety (n = 37; 5.1%) and ADD/ADHD (n = 31; 4.2%) were reported as well.
“In the overall patient population, the main body surface area affected by atopic dermatitis was 33.3%, and the main Eczema Area and Severity Index or EASI was 14.4, with a range of 0 to 72 in the score,” Paller said. “Similar results were seen among age subgroups.”
Patient and caregiver reported outcomes indicated moderate impact on quality of life, Paller said, whereas Infants’ Dermatitis Quality of Life Index and Children’s Dermatology Quality of Life Index values indicated a moderate to very large effect on quality of life.
Patient Oriented Eczema Measure values showed moderate disease severity, Paller continued, with high proportions of children suffering daily from dry, rough, itchy, cracked and flaking skin, Paller said.
For example, 65% of participants experienced itching that affected their skin or sleep each day in the previous week. Meanwhile, 62% experienced dry or rough skin, 40.7% reported cracked skin, 39.2% had flaking and 19.7% experienced bleeding that impacted their skin or sleep each day in the previous week.
Specifically, 31.6% reported disturbed sleep each day the previous week due to their atopic dermatitis, with 9.6% experiencing disturbed sleep on 5 or 6 days, 18.4% on 3 or 4 days, 19.6% on 1 or 2 days and 20.9% whose sleep was not disturbed at all.
“These interim baseline data from PEDISTAD show a multidimensional disease burden characterized by a very early onset of atopic dermatitis, itch and sleep disturbance, and quality-of-life impairment demonstrating a substantial impact of the disease on children, likely reflecting undertreatment due to the lack of safe and effective long-term therapeutic options,” Paller said.