Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
J Dermatolog Treat. 2023 Dec;34(1):2222201. doi: 10.1080/09546634.2023.2222201.
Patients with moderate-to-severe atopic dermatitis (AD) experience skin lesions and intense itch that substantially affect quality of life. Patients have choices among systemic AD treatments that offer varied benefit-risk profiles.
Measure patients' willingness to trade off the risks and benefits of systemic treatments among individuals with a physician-confirmed diagnosis of moderate-to-severe AD.
Patients participated in a discrete choice experiment online survey with a series of choices between hypothetical AD treatments defined by six attributes reflecting benefits and risks of treatments (itch reduction, time until noticeable itch reduction, chance of clear or almost clear skin, risk of serious infection, risk of developing acne, and need for prescription topical steroids). Data were analyzed with a random parameters logit model to quantify preferences and the relative importance of attributes for treatment alternatives.
Respondents ( = 200) placed the highest relative importance on itch reduction, speed of itch reduction, and skin clearance, and were generally willing to accept clinically relevant levels of risk of serious infection and acne in exchange for treatment benefits.
Patients with moderate-to-severe AD were willing to trade clinically relevant treatment risks for greater or more rapid itch reduction and skin clearance offered by systemic therapies.
中重度特应性皮炎(AD)患者会出现皮肤损伤和剧烈瘙痒,这极大地影响了他们的生活质量。患者在具有不同获益-风险特征的全身性 AD 治疗方案中有多种选择。
在经医生确诊的中重度 AD 患者中,衡量患者对全身性治疗方案的风险与获益权衡的意愿。
患者参与了一项在线离散选择实验调查,对六种反映治疗获益和风险的假设性 AD 治疗方案进行了一系列选择(瘙痒缓解程度、瘙痒缓解时间、皮肤达到明显改善的可能性、发生严重感染的风险、发生痤疮的风险和需要处方外用皮质类固醇的可能性)。采用随机参数对数模型对数据进行分析,以量化偏好和各治疗方案属性的相对重要性。
受访者(n=200)最看重瘙痒缓解程度、瘙痒缓解速度和皮肤改善程度,并且通常愿意接受与严重感染和痤疮相关的临床相关风险,以换取治疗获益。
中重度 AD 患者愿意为全身性治疗方案带来的更快或更显著的瘙痒缓解和皮肤改善程度而承担临床相关的治疗风险。