Skin itching and pain in patients with AD linked to significant burden on quality of life

The significant burden on quality of life associated with symptoms of itching and/or skin pain in patients with atopic dermatitis (AD) may warrant alternative approaches to address unmet needs.

According to the results of a Japanese study recently published in Current medical research and opinion.

As 2 of the most common and distressing symptoms associated with AD, skin itchiness and pain have both been shown in research to have significant impacts on work productivity and quality of life for patients.

In addition, the presence of comorbidities such as sleep disturbances and mental health disorders, which are more common in people with Alzheimer’s disease, can further exacerbate the risk of adverse health effects and lead to a increased use of health care resources.

“It is known that AD patients in Japan experience a high disease burden due to symptoms affecting sleep, quality of life and work productivity,” the authors wrote, emphasizing the need for the study. “However, there is limited evidence of the frequency that skin pain is experienced alongside itching and their combined impact on AD patients in Japan.”

They performed an analysis of data derived from the 2020 Adelphi Disease Specific Program (DSP), a one-time cross-sectional survey of dermatologists (n=56) and their patients with a history of moderate to severe Alzheimer’s disease ( N = 265), to assess additional double burden and the impact of skin itch and pain on satisfaction, quality of life, and work productivity in patients from Japan.

Data were collected between April and September 2019 and stratified by patient characteristics, including no itch/skin pain (no I/SP, reference group, n=89), itch/no pain skin (I only, n = 71), and skin itching and pain (I + SP, n = 26).

Quality of life was assessed using the Dermatologic Quality of Life Index (DLQI; range 0-30); the Patient-Oriented Eczema Measure (POEM) assessed the presence of signs and symptoms of Alzheimer’s disease in the past week and their impact on sleep; The Work Productivity and Activity Index (WPAI) assessed the effects of AD on productivity over the past 7 days (range 0-100). Descriptive analyzes were performed alongside a range of regression models, depending on the outcome variables.

Compared to the reference group, patients in the I+SP and I-only groups had significantly worse scores for satisfaction, quality of life and work productivity:

  • patients in the I + SP group showed a lower POEM score of 4.97 points (P =.005) and 14.5% more overall work disability (P = .034)
  • patients in the I-only and I+SP groups were 8.92 and 23.5 times more likely to have daily sleep disturbance, respectively (both, P
  • I+SP patients were 4.6 times more likely to be bothered by their symptoms (P = 0.034), had an average EASI score 6.7 points higher (P = 0.008), and had 1.39 additional areas affected (P = .001)
  • I+SP patients were 7.26 times more likely to express dissatisfaction with the lack of improvement in their condition and 8 times more likely to be dissatisfied with the convenience of treatment (both, P

“This dissatisfaction, together with the variations in reported symptom loads, suggests that physicians may consider alternative and/or novel therapeutic approaches for the management of skin itch and pain,” the researchers concluded.

Reference

Torisu-Itakura H, Anderson P, Piercy J, Pike J, Sakamotoa A, Kabashima K. Impact of skin itch and pain on the quality of life of adult patients with atopic dermatitis in Japan: results from a real world, point -in- time, survey of doctors and patients. Opinion on the res. med. current. July 5, 2022; 1-10. doi:10.1080/03007995.2022.2092352