The prevalence of atopic dermatitis (AD) among U.S. adults may be higher than previously thought, suggesting resources dedicated to managing the condition may be insufficient, researchers from the Perelman School of Medicine at the University of Pennsylvania (Penn) report.
Published online ahead of print in The Journal of Investigative Dermatology (Oct. 30, 2018), the sutdy involved a survey of 1,278 adults sampled from the GfK Knowledge Panel, a probability-based online survey panel.
The survey revealed that 7.3% of respondents met the criteria for diagnosis of AD, 60% of those with AD were classified as mild, 29% as moderate, and 11% as severe. The researchers then used U.S. census population data to project that 16.5 million U.S. adults are living with AD, with 6.6 million of those cases being moderate-to-severe. The patients with more severe disease also had higher scores in other patient-reported outcome measures, including the Dermatology Life Quality Index (DLQI), and an increased likelihood of anxiety or depression as measured by the Hospital Anxiety and Depression Scale (HADS).
“We tend to think of this disease as a children’s disease, but our data show that’s not the case,” said the study’s lead author Dr. Zelma C. Chiesa Fuxench, in a press release. “Our findings show this disease affects seven per cent of the population, far more than other inflammatory conditions like psoriasis, which only affects about three per cent. Yet psoriasis has eight biologic treatments available for patients, whereas atopic dermatitis only has one that’s approved.”
Dr. Fuxench is an assistant professor of dermatology at Penn.
The findings also raise larger questions about this population, said Dr. Fuxench, such as whether these individuals developed AD as they grew older, or whether they developed it in childhood but stopped seeking treatment due to poor response or dissatisfaction with the therapies available.
She noted that many patients are told they will grow out of AD, but the data in this paper suggests that may not be the case. Instead, the condition may change over time.
“Topical and oral corticosteroids don’t work for everyone, and even when they do, patients should not be on them long-term,” Dr. Fuxench said. “We need to prioritize our understanding of this complex disease as well as the development of innovative therapies for these patients.”
The research was completed in collaboration with the Asthma and Allergy Foundation of America in partnership with the National Eczema Association, sponsored by Sanofi Genzyme and Regeneron. Sanofi Genzyme and Regeneron manufacture dupilumab, a biologic medication used to treat AD, but they had no involvement in the research.