547 - Clinical burden and work productivity impairment in moderate-to-severe atopic dermatitis patients in the United States
Authors: Feldman Steven R , Guerin Annie , Gauthier-Loiselle Marjolaine , Claxton Ami J , Hazra Nisha C , Meng Yan , Gallant Kirsten , Balu Sanjeev 
Published: February 2024

Abstract

Introduction/Background
Atopic dermatitis (AD) is a common chronic condition affecting 5-10% of adults worldwide. AD symptoms (e.g., itching) can lead to sleep disturbances and affect daily activity and work productivity.

Objectives
With the evolving treatment landscape for moderate-to-severe AD, including advanced systemic therapies like biologics and Janus-kinase (JAK) inhibitors, a contemporary appraisal of the clinical burden and impairment in patients with moderate-to-severe AD in the United States (US) is warranted.

Methods
A web-based survey was conducted in June 2023 among US adults (≥ 18 years) with self-reported moderate-to-­severe AD or who had experience with systemic therapy, were diagnosed with AD for ≥ 1 year, and with inadequate response to topical treatments. Demographic and clinical characteristics (e.g., comorbidities, body regions ever affected by AD) at the time of the survey were summarized descriptively, along with productivity/activity burden (i.e., activity impairment, work impairment, absenteeism, presenteeism) using the Workers Productivity and Impairment Activity Index (WPAI). Analyses were reported overall and separately for White, Black, and Asian participants.

Results
300 participants from all US regions completed the survey (White: 234 [78.0%], Black: 37 [12.3%], Asian: 16 [5.3%], Other/Unknown: 13 [4.4%]). Overall, participants’ mean age was 45 years, 70% were female, and 66% were employed. Half had experienced severe symptoms at any time (50%), and 52% had experience with systemic therapy. At the time of the survey, over 90% of participants were receiving treatment for AD, and 20% self-reported current symptoms as mild (moderate: 69%, severe: 11%). Approximately half reported AD affected their face (46%), neck (52%), or feet (54%) at any time. The most frequently reported comorbidities were anxiety (53%), depression (39%), high blood pressure (25%), allergic rhinitis (24%), and asthma (22%). Most participants (85%) reported some activity impairment due to AD with a mean activity impairment score of 37.6%. A majority (82%) of employed participants reported some work impairment due to AD with a mean overall work impairment score of 38.5%, absenteeism of 7.1% and presenteeism of 36.0%. Race-stratified analysis indicated that Black patients were diagnosed at a younger age, with a numerically higher proportion reporting severe disease (70%) and more affected by AD on the face (54%), neck (68%), and feet (62%) at any time compared to White and Asian patients. All race groups reported substantial activity impairment (33.0%-38.6%) and work impairment (27.2%-39.9%).

Conclusions
Moderate-to-severe AD is associated with a high disease burden with severity of symptoms across the US population, leading to substantial activity and productivity impairments. Given half of the patients in this study had never received systemic therapy, wider use of available treatment options may improve disease and symptom management, thereby reducing activity and work impairment.