A real-world study evaluating adeQUacy of Existing Systemic Treatments for patients with moderate-to-severe Atopic Dermatitis (QUEST-AD)

Background: Systemic therapies are commonly used for patients with uncontrolled moderate-to-severe atopic dermatitis (AD) and impaired quality of life (QoL). However, real-world treatment patterns and unmet needs of adults with moderate-to-severe AD receiving systemic therapies are poorly quantified. Objective: To evaluate unmet needs in patients with moderate-to-severe AD treated with systemic therapies. Methods: Adults with AD diagnosis in past 5 years and a prescription for systemic treatment or phototherapy in past 6 months were identified from the Optum Research Database. Patients completed a survey about symptoms, treatment, and QoL. Chi-squared and t tests analyzed bivariable comparisons of demographics and outcomes. Spearman's rank-order correlation analyses examined the relationship between frequency of flares and outcomes. Results: Eight hundred and one participants were included (mean age, 45.2 years; 71.8% female). In the 12 months before baseline survey, 38.3% reported no remission from AD. In the month before baseline survey, 63.6% used topical corticosteroids, and 81.3% of patients experienced 1 or more flares. Patients experiencing flares reported worse Patient-Orientated Eczema Measure (POEM), Peak Pruritus Numeric Rating Scale (NRS), and Dermatology Life Quality Index scores (DLQI), lower treatment satisfaction, and greater work productivity loss than patients without flares (all P < .001). Patients with severe atopic dermatitis reported worse POEM, Peak Pruritus NRS, and DLQI, lower treatment satisfaction, and greater work productivity loss than patients with moderate AD (all P <. 001). Conclusion: Despite receiving systemic therapies, adults with moderate-to-severe AD reported disease symptoms, recurrent flares, and impaired QoL, suggesting unmet therapeutic needs. (C) 2019 American College of Allergy, Asthma & Immunology.