OBJECTIVES : Atopic dermatitis (AD) is a relapsing chronic inflammatory skin disease characterized by pruritus/eczematous lesions. The objective was to describe clinical and humanistic burden of mild to moderate (M2M) AD in Europe.

METHODS : Data from the 2017 National Health and Wellness Survey, a global cross-sectional self-reported survey, from France, Germany, Italy, Spain, and UK were evaluated. Adults self-reporting AD/eczema (AD/ECZ) were compared with respondents without AD/ECZ using propensity score matching. Demographics and health characteristics were evaluated using Chi-square tests and one-way analysis of variance (ANOVA) for categorical and continuous variables, respectively. Variables which differed between groups (p<0.10) were entered into a logistic regression model to predict AD/ECZ status. Differences across severity (mild, moderate, severe) vs. matched controls, for comorbidities, quality of life, work-related outcomes and psychosocial burden were assessed using Chi-square/ANOVA tests. Similar evaluations were performed using Dermatology Life Quality Index (DLQI) severity bands. Self-reported data provided patient-centered assessments of burden; however, a study limitation was not having clinician-confirmed diagnosis or severity assessment.

RESULTS : A total of 4,208 AD/ECZ patients, mean age 45.6, 68.1% female were included. Among 4,039 with self-reported M2M severity, considerable comorbidity burden was observed, most commonly allergies (40.0% mild-48.2% moderate vs. 22.2% control), pain (31.6% -35.1% vs. 22.4%, and allergic rhinitis (26.1%-25.0% vs. 22.6%). Increased burden was consistently observed for: impact/severity of sleep difficulties, Short Form-36 (SF-36) (Mental Component Summary Score, Physical Component Summary Score, 8 domain scores), EuroQOL (EQ-5D) index, work/activity level (absenteeism, activity impairment). Increased frequency of self-reported anxiety (41.4%-45.7% vs. 32.2%) and for moderate/severe depression (23.8%-31.3% vs. 20.6%) was observed. Increased moderate/severe sleep difficulties were also reported (23.1%-34.5% vs. 18.9%).

CONCLUSIONS : Clinical and humanistic burden was consistently observed across multiple self-reported assessments in M2M AD respondents in Europe compared to matched controls. This highlights the importance of improving disease management in this population.