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Patient perspectives on the management of atopic dermatitis - 17/08/11

Doi : 10.1016/j.jaci.2006.02.031 
Torsten Zuberbier, MD a, , Seth J. Orlow, MD, PhD b, Amy S. Paller, MD c, Alain Taïeb, MD d, Roger Allen, MBChB, FRCP e, José M. Hernanz-Hermosa, MD, PhD f, Jorge Ocampo-Candiani, MD g, Margaret Cox h, Joanne Langeraar i, Jan C. Simon, MD j
a From the Department of Dermatology and Allergy, Allergy Centre Charité, Charité–Universitätsmedizin Berlin 
b New York University School of Medicine, New York 
c Departments of Dermatology and Pediatrics, Northwestern University’s Feinberg School of Medicine, Chicago 
d CHU de Bordeaux, Bordeaux 
e Queens Medical Centre, Nottingham 
f Hospital General Universitario Gregorio Marañon, Madrid 
g Hospital Universitario, Universidad Autonoma de Nuevo León, Monterrey 
h National Eczema Society, London 
i National Eczema Association for Science and Education, San Rafael 
j Department of Dermatology, Venerology and Allergology, Universitätsklinikum Leipzig 

Reprint requests: Torsten Zuberbier, MD, Department of Dermatology and Allergy, Allergy Centre Charité, Schumannstrasse 20-21, D-10117 Berlin, Germany.

Berlin and Leipzig, Germany, New York, NY, Chicago, Ill, Bordeaux, France, Nottingham and London, United Kingdom, Madrid, Spain, Monterrey, Mexico, and San Rafael, Calif

Abstract

Background

Atopic dermatitis (AD) is increasingly common, with a point prevalence of more than 30% in some countries, and is characterized by visible skin lesions and intense itching.

Objective

The International Study of Life with Atopic Eczema (ISOLATE) is the first large-scale study to assess the effect of AD on the lives of patients and society, how patients and caregivers manage the condition, and how well patients and caregivers currently believe that AD is controlled.

Methods

Two thousand two patients (>13 years) and caregivers of children (2-13 years) with moderate-to-severe AD randomly selected from 8 countries underwent standardized telephone interviews using questions developed in collaboration with national eczema patient groups and physicians.

Results

During each year, patients spend, on average, 1 of 3 days in flare. The majority of patients receive prescription topical corticosteroids to treat flares; however, 49% of respondents are concerned about using these agents. On average, patients and caregivers delay initiating treatment for 7 days after onset of a flare. Only 24% of patients and caregivers feel confident they can manage AD flares adequately. Seventy-five percent of caregivers and patients feel that being able to effectively control AD would be the single most important improvement to their or their child’s quality of life. The avoidable secondary economic cost of AD is estimated at €2 billion per year across the European Union.

Conclusion

ISOLATE highlights the need to improve patients’ control of AD to reduce the significant effect this condition has on the patient and society.

Clinical implications

ISOLATE shows that patients with AD are untreated for half the time they are in flare, and thus there is an urgent need for physicians to ensure that the patients are educated and confident in using medication as prescribed to gain disease control.

Le texte complet de cet article est disponible en PDF.

Key words : Flare, patient management, atopic dermatitis, atopic eczema, International Study of Life with Atopic Eczema

Abbreviations used : AD, ISOLATE, PIQoL-AD, QoLIAD


Plan


 This study was supported by an unrestricted educational grant from Novartis Pharma AG.
Disclosure of potential conflict of interest: T. Zuberbier has consultant arrangements with and is on the speakers’ bureau for Novartis. S. Orlow has consultant arrangements with and is on the speakers’ bureau for Novartis and Astellas. A. Paller has speaker and consultant arrangements with Novartis. A. Taïeb has consultant arrangements with and has received a travel grant from Novartis. R. Allen is on the speakers’ bureau for Novartis. J. Ocampo-Candiani has received a travel grant from Novartis. M. Cox works for the National Eczema Society, which works closely with the pharmaceutical industry. J. Langeraar works for the Nation Eczema Association for Science and Education, which has received financial support from Astellas and Novartis. J. Simon has consultant arrangements with and is on the speakers’ bureau for Novartis.


© 2006  American Academy of Allergy, Asthma and Immunology. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 118 - N° 1

P. 226-232 - juillet 2006 Retour au numéro
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