Atoderma: Clinical and Economic Burden of Moderate to Severe Atopic Dermatitis in the Czech Republic

OBJECTIVES: Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease with episodes of flares affecting 1-5% of adults in Europe. This study explores AD’s clinical and economic burden in the Czech Republic.

METHODS: A cross-sectional questionnaire-based study among Czech moderate to severe AD patients and their physicians-dermatologists collect socio-demographic, clinical and cost data, including responses from validated questionnaires: DLQI (Dermatology Life Quality Index), EQ-5D-5L, JSEQ (Jenkins Sleep Evaluation Questionnaire), CUDOS (Clinically Useful Depression Outcome Scale), CUXOS (Clinically Useful Anxiety Outcome Scale), and WPAI:AD (Work Productivity and Activity Impairment: Atopic Dermatitis).

RESULTS: In total, 59 adult patients completed the study. Their mean age was 45 years, with 58% of females.

The mean severity of AD assessed by physicians using VAS (Visual Analogue Scale) was 51.5 on the scale 0-100. According to the EASI (Eczema Area Severity Index), 53% of patients had moderate, 44% severe, and 3% very severe disease.

Patients' mean DLQI score was 11.1, the mean EQ-5D utility index was 0.667, the mean patient-reported VAS was 57.5, and the mean JESQ score was 9.4. The average level of depression of the patients was 20.1 (CUDOS) and average degree of anxiety was 18.2 (CUXOS). The average loss of work productivity was estimated to 31.0%, according to WPAI: AD (5.1% absenteeism, 27.5% presenteeism).

Over the past six months, patients attended, on average, 3.8 planned and 1.5 unplanned doctor visits due to AD. Per week, patients spent an average of 4.5h preparing and taking medications, 3.5h on special hygiene care, 2.6h on special cleaning, and 1.8h on meal preparation.

The total direct costs of patients, including transport, drugs, medical devices, and other needs, was €244/month.

CONCLUSIONS: The study revealed a significant clinical and economic burden of the disease that may be relevant when evaluating innovative AD treatments.