Introduction <p>Atopic dermatitis (AD), a chronic inflammatory condition, is the leading cause of global burden from skin disease. Optimal targets for clinician-reported outcomes (ClinROs) and patient-reported outcomes (PROs), including minimal disease activity (MDA; defined as simultaneous achievement of ≥ 1 optimal ClinRO and ≥ 1 optimal PRO), were established following the Aiming High in Eczema/Atopic Dermatitis (AHEAD) initiative. This study evaluated the impact of MDA achievement on flare activity, healthcare resource utilization, and patient-reported disease control in adults with moderate-to-severe AD.</p> Methods <p>This retrospective post&#xa0;hoc analysis used data from the real-world cross-sectional MEASURE-AD study and included adults with moderate-to-severe AD across 28 countries. Three definitions were used to identify achievement of MDA. Outcomes were measured using patient-reported questionnaires evaluating flare activity and healthcare resource utilization over the preceding 6&#xa0;months, as well as patient-reported disease control assessed at the time of the questionnaire. Statistical analyses compared patients achieving MDA targets with non-MDA groups using Kruskal–Wallis tests.</p> Results <p>Patients achieving MDA experienced fewer flares (means ranging from 0.8 to 1.4) compared with non-MDA groups (3.8–9.8) over the preceding 6&#xa0;months. Flares were shorter in duration, with 9.9–13.4% of patients who achieved MDA reporting flares longer than 7&#xa0;days compared with 26.4–51.1% of patients across non-MDA groups. Patients who met neither optimal ClinRO or PRO reported a 2.2- to 2.7-fold increase in average number of healthcare visits compared with MDA groups. More patients who achieved MDA indicated complete agreement that their AD was effectively controlled (86.7–94.2%) compared with those who did not achieve MDA (19.2–74.1%).</p> Conclusions <p>Achievement of MDA in patients with moderate-to-severe AD was associated with less frequency and duration of flares, reduced healthcare resource utilization, and increased patient-reported disease control compared with those who did not achieve MDA. These findings emphasize the importance of holistic assessments when evaluating treatment outcomes in AD.</p> Trial Registration <p> ClinicalTrials.gov Identifiers NCT03569293 (Measure Up&#xa0;1), NCT03607422 (Measure Up&#xa0;2), and NCT03568318 (AD Up).</p>

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Achieving Minimal Disease Activity in Atopic Dermatitis Is Associated with Fewer Flares, Reduced Healthcare Resource Utilization, and Improved Disease Control: Analysis from the Real-World MEASURE-AD Study

  • Jonathan I. Silverberg,
  • Vimal H. Prajapati,
  • Susanne Abraham,
  • Alan D. Irvine,
  • Melinda J. Gooderham,
  • Emma Guttman-Yassky,
  • Hideaki Tanizaki,
  • Marius Rademaker,
  • Shirley H. Chen,
  • Alvaro Moreira,
  • Richard Ta,
  • Wan-Ju Lee,
  • Kilian Eyerich

摘要

Introduction

Atopic dermatitis (AD), a chronic inflammatory condition, is the leading cause of global burden from skin disease. Optimal targets for clinician-reported outcomes (ClinROs) and patient-reported outcomes (PROs), including minimal disease activity (MDA; defined as simultaneous achievement of ≥ 1 optimal ClinRO and ≥ 1 optimal PRO), were established following the Aiming High in Eczema/Atopic Dermatitis (AHEAD) initiative. This study evaluated the impact of MDA achievement on flare activity, healthcare resource utilization, and patient-reported disease control in adults with moderate-to-severe AD.

Methods

This retrospective post hoc analysis used data from the real-world cross-sectional MEASURE-AD study and included adults with moderate-to-severe AD across 28 countries. Three definitions were used to identify achievement of MDA. Outcomes were measured using patient-reported questionnaires evaluating flare activity and healthcare resource utilization over the preceding 6 months, as well as patient-reported disease control assessed at the time of the questionnaire. Statistical analyses compared patients achieving MDA targets with non-MDA groups using Kruskal–Wallis tests.

Results

Patients achieving MDA experienced fewer flares (means ranging from 0.8 to 1.4) compared with non-MDA groups (3.8–9.8) over the preceding 6 months. Flares were shorter in duration, with 9.9–13.4% of patients who achieved MDA reporting flares longer than 7 days compared with 26.4–51.1% of patients across non-MDA groups. Patients who met neither optimal ClinRO or PRO reported a 2.2- to 2.7-fold increase in average number of healthcare visits compared with MDA groups. More patients who achieved MDA indicated complete agreement that their AD was effectively controlled (86.7–94.2%) compared with those who did not achieve MDA (19.2–74.1%).

Conclusions

Achievement of MDA in patients with moderate-to-severe AD was associated with less frequency and duration of flares, reduced healthcare resource utilization, and increased patient-reported disease control compared with those who did not achieve MDA. These findings emphasize the importance of holistic assessments when evaluating treatment outcomes in AD.

Trial Registration

ClinicalTrials.gov Identifiers NCT03569293 (Measure Up 1), NCT03607422 (Measure Up 2), and NCT03568318 (AD Up).