Chu Chia-Yu, Chan Yung, Wananukul Siriwan, Cheng Hao, Chandran Nisha Suyien, Bhat Ramesh, Son Sang Wook, Liao Han-Fang, Gardiner Sean, Ng Qi Qing, Yeo See-Hwee, Chen Sophie Bozhi, Kataoka Yoko
Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Apex Dermatology Institute, Hong Kong, China.
Dermatol Ther (Heidelb). 2024 Sep;14(9):2479-2493. doi: 10.1007/s13555-024-01244-7. Epub 2024 Aug 5.
The burden of atopic dermatitis (AD) is significant, with a substantial impact on quality of life (QoL). This cross-sectional study aimed to ascertain the burden of AD, its impact on QoL, and associated costs.
Patients with moderate-to-severe AD were enrolled from eight territories, namely Hong Kong, India, Japan, Mainland China, Singapore, South Korea, Taiwan, and Thailand. After screening was performed and informed consent was obtained, eligible participants were asked to provide responses on their AD symptoms, severity, treatment, and out-of-pocket costs via an online survey. QoL was assessed using EQ-5D-5L and Dermatology Life Quality Index (DLQI), while productivity loss was quantified using the Work Productivity and Activity Impairment (WPAI) questionnaire. Data from completed submissions were analyzed using descriptive statistics. The study was reviewed by the institutional review board in each territory.
Median age of enrolled patients (N = 1103) was 41.0 years (interquartile range, IQR 16.0). The majority of patients reported that their head/neck, trunk, upper limbs, and lower limbs were affected during a flare. Topical (74.2%) and oral steroids (58.7%) were frequently prescribed to manage AD. Common atopic comorbidities were allergic urticaria (64.2%), allergic rhinitis (61.8%), and allergic conjunctivitis (51.5%). Median DLQI score was 13.0 (IQR 11.0), while median EQ-5D-5L (based on China value set) score was 0.8 (IQR 0.4); 87.2% and 77.2% of patients reported pain/discomfort and anxiety/depression on the EQ-5D-5L domains, respectively. Median total annual costs associated with AD were USD 10,128.52 (IQR 12,963.26) per patient, with indirect costs being the largest component. Findings from WPAI indicated that presenteeism is a major contributor to productivity loss.
This multinational survey study showed that AD is associated with substantial QoL impairment and economic burden among Asian adult patients with moderate-to-severe AD. To alleviate burden of AD, clinicians should be more proactive in managing other concomitant conditions including psychological issues, and advocate for increased reimbursement for AD treatments.
特应性皮炎（AD）的负担很重，对生活质量（QoL）有重大影响。这项横断面研究旨在确定AD的负担、其对生活质量的影响以及相关成本。
从八个地区招募中重度AD患者，即中国香港、印度、日本、中国大陆、新加坡、韩国、中国台湾和泰国。在进行筛查并获得知情同意后，符合条件的参与者被要求通过在线调查提供有关其AD症状、严重程度、治疗和自付费用的信息。使用EQ-5D-5L和皮肤病生活质量指数（DLQI）评估生活质量，同时使用工作生产力和活动障碍（WPAI）问卷对生产力损失进行量化。对已完成提交的数据进行描述性统计分析。该研究在每个地区均经过机构审查委员会的审查。
入组患者（N = 1103）的中位年龄为41.0岁（四分位间距，IQR 16.0）。大多数患者报告在发作期间其头颈部、躯干、上肢和下肢均受到影响。外用药物（74.2%）和口服类固醇（58.7%）是治疗AD的常用药物。常见的特应性合并症有过敏性荨麻疹（64.2%）、过敏性鼻炎（61.8%）和过敏性结膜炎（51.5%）。DLQI评分中位数为13.0（IQR 11.0），而EQ-5D-5L（基于中国价值集）评分中位数为0.8（IQR 0.4）；分别有87.2%和77.2%的患者在EQ-5D-5L领域报告有疼痛/不适和焦虑/抑郁。每位患者与AD相关的年度总费用中位数为10,128.52美元（IQR 12,963.26），其中间接成本是最大组成部分。WPAI的研究结果表明，出勤主义是生产力损失的主要原因。
这项多国调查研究表明，AD与亚洲中重度AD成年患者的生活质量严重受损和经济负担相关。为减轻AD的负担，临床医生应更积极地管理包括心理问题在内的其他伴随疾病，并倡导增加AD治疗的报销。
