1
|
Otsuka A, Wang C, Torisu-Itakura H, Matsuo T, Isaka Y, Anderson P, Piercy J, Austin J, Marwaha S, Tanaka A. Patient and family burden in pediatric atopic dermatitis and its treatment pattern in Japan. Int J Dermatol 2024. [PMID: 38812086 DOI: 10.1111/ijd.17256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/19/2024] [Accepted: 04/29/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND This study evaluated the level of burden in pediatric and adolescent atopic dermatitis (AD) patients in Japan, the associated burden on caregivers/families, and whether this burden varied with age. METHODS Data were drawn from the Adelphi Pediatric AD Disease Specific Programme (DSP)™, a cross-sectional survey of physicians and their patients conducted in Japan between July and December 2022. Physicians reported patient demographics, clinical characteristics, disease burden, and current/previous therapies. Patients and/or caregivers reported perceived disease severity and impact of AD, including the Children's Dermatology Life Quality Index (CDLQI) and Dermatitis Family Impact questionnaire (DFI). RESULTS Overall, 55 physicians provided data for 537 AD patients aged ≤17. Mean (SD) overall scores for CDLQI, POEM, and DFI were 9.3 (6.3), 8.3 (6.8), and 11.7 (7.2), respectively. Age was associated with higher patient and/or caregiver-reported CDLQI scores, which increased by 0.543 points per year of age (P = 0.01). Patients with severe disease reported a more significant impact on quality of life factors compared with mild patients (P < 0.001). Age was associated with higher caregiver-reported burden, with DFI scores increasing by 0.325 per year (P = 0.01). Physician-reported impact on caregivers showed that age was significantly associated with increased burden on sleep, daily activities, work, and mood (P < 0.05), with disease severity associated with impact across all factors (P < 0.01). CONCLUSIONS Both increasing age and disease severity were associated with the increased impact of AD on patients and their caregivers. Disease control/modification through appropriate therapeutic intervention at a younger age may relieve the burden of pediatric AD on patients and their families.
Collapse
Affiliation(s)
- Atsushi Otsuka
- Department of Dermatology, Kindai University Faculty of Medicine, Osaka, Japan
| | | | | | | | | | | | | | | | | | - Akio Tanaka
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
2
|
Faye O, Flohr C, Kabashima K, Ma L, Paller AS, Rapelanoro FR, Steinhoff M, Su JC, Takaoka R, Wollenberg A, Yew YW, Postigo JAR, Schmid-Grendelmeier P, Taïeb A. Atopic dermatitis: A global health perspective. J Eur Acad Dermatol Venereol 2024; 38:801-811. [PMID: 38151270 DOI: 10.1111/jdv.19723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/17/2023] [Indexed: 12/29/2023]
Abstract
The International Society of AD (ISAD) organized a roundtable on global aspects of AD at the WCD 2023 in Singapore. According to the Global Burden of Disease (GBD) consortium, at least 171 million individuals were affected with AD in 2019, corresponding to 2.23% of the world population, with age-standardized prevalence and incidence rates that were relatively stable from 1990 to 2019. Based on the panel experience, most AD cases are mild-to-moderate. Without parallel data on disease prevalence and severity, the GBD data are difficult to interpret in many regions. This gap is particularly important in countries with limited medical infrastructure, but indirect evidence suggests a significant burden of AD in low-and-medium resource settings, especially urban areas. The Singapore roundtable was an opportunity to compare experiences in World Bank category 1 (Madagascar and Mali), 3 (Brazil, China) and 4 (Australia, Germany, Qatar, USA, Singapore, Japan) countries. The panel concluded that current AD guidelines are not adapted for low resource settings and a more pragmatic approach, as developed by WHO for skin NTDs, would be advisable for minimal access to moisturizers and topical corticosteroids. The panel also recommended prioritizing prevention studies, regardless of the level of existing resources. For disease long-term control in World Bank category 3 and most category 4 countries, the main problem is not access to drugs for most mild-to-moderate cases, but rather poor compliance due to insufficient time at visits. Collaboration with WHO, patient advocacy groups and industry may promote global change, improve capacity training and fight current inequalities. Finally, optimizing management of AD and its comorbidities needs more action at the primary care level, because reaching specialist care is merely aspirational in most settings. Primary care empowerment with store and forward telemedicine and algorithms based on augmented intelligence is a future goal.
Collapse
Affiliation(s)
- Ousmane Faye
- Department of Dermatology, Faculty of Medicine and Odontostomatology, Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Carsten Flohr
- Paediatric & Population-Based Dermatology Research, St John's Institute of Dermatology, London, UK
- Guy & St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Kenji Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Singapore Research Institute of Singapore (SRIS), Kyoto, Japan
- A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology, and Research (A*STAR)Biopolis, Singapore City, Singapore
| | - Lin Ma
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Amy S Paller
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Martin Steinhoff
- Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
- College of Medicine, Qatar University, Doha, Qatar
- School of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
- Department of Dermatology, Weill Cornell Medicine, New York City, New York, USA
| | - John C Su
- Eastern Health, Monash University, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, University of Melbourne, Melbourne, Victoria, Australia
| | - Roberto Takaoka
- International Society of Atopic Dermatitis, Davos, Switzerland
- Division of Dermatology, University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - Andreas Wollenberg
- International Society of Atopic Dermatitis, Davos, Switzerland
- Division of Dermatology, University of São Paulo Medical School Hospital, São Paulo, Brazil
- University Hospital Augsburg, Augsburg, Germany
- Ludwig-Maximilian University, Munich, Germany
| | | | | | - Peter Schmid-Grendelmeier
- International Society of Atopic Dermatitis, Davos, Switzerland
- World Allergy Organization, Milwaukee, Wisconsin, USA
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
- Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland
| | - Alain Taïeb
- International Society of Atopic Dermatitis, Davos, Switzerland
- INSERM U 1312, University of Bordeaux, Bordeaux, France
| |
Collapse
|
3
|
ISHIDA Y, YONOICHI S, HARA Y, SHODA A, KIMURA M, MURATA M, ITO M, NUNOBIKI S, YOSHIMOTO A, MANTANI Y, YOKOYAMA T, HIRANO T, MATSUO E, IKENAKA Y, HOSHI N. Effect of clothianidin exposure at the no-observed-adverse-effect level (NOAEL) in a mouse model of atopic dermatitis. J Vet Med Sci 2024; 86:333-339. [PMID: 38311400 PMCID: PMC10963095 DOI: 10.1292/jvms.23-0515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 01/24/2024] [Indexed: 02/10/2024] Open
Abstract
The effects of exposure to clothianidin (CLO), a neonicotinoid pesticide (NN), on the thymus and intestinal microbiota were recently revealed. Immune cells express nicotinic acetylcholine receptors (nAChRs), an NN target, suggesting CLO may disrupt the immune system. However, the relationship between CLO and atopic dermatitis (AD) is unknown. We administered a no-adverse-effect-level (NOAEL) dose of CLO to male NC/Nga mice with induced AD and measured, at three time points, key AD symptom indicators: epidermal thickening, mast cell number, total plasma IgE, and histamine levels. CLO increased total plasma IgE levels but reduced epidermal thickening, mast cell number, and plasma histamine levels in the early stages of AD. This demonstrates for the first time that CLO exposure inhibits AD's early symptoms.
Collapse
Affiliation(s)
- Yuya ISHIDA
- Laboratory of Animal Molecular Morphology, Department of Animal Science, Graduate School of Agricultural Science, Kobe University, Hyogo, Japan
| | - Sakura YONOICHI
- Laboratory of Animal Molecular Morphology, Department of Animal Science, Graduate School of Agricultural Science, Kobe University, Hyogo, Japan
| | - Yukako HARA
- Laboratory of Animal Molecular Morphology, Department of Animal Science, Graduate School of Agricultural Science, Kobe University, Hyogo, Japan
| | - Asuka SHODA
- Laboratory of Animal Molecular Morphology, Department of Animal Science, Graduate School of Agricultural Science, Kobe University, Hyogo, Japan
| | - Mako KIMURA
- Laboratory of Animal Molecular Morphology, Department of Animal Science, Graduate School of Agricultural Science, Kobe University, Hyogo, Japan
| | - Midori MURATA
- Laboratory of Animal Molecular Morphology, Department of Animal Science, Graduate School of Agricultural Science, Kobe University, Hyogo, Japan
| | - Makiko ITO
- Laboratory of Animal Molecular Morphology, Department of Animal Science, Graduate School of Agricultural Science, Kobe University, Hyogo, Japan
| | - Sarika NUNOBIKI
- Laboratory of Animal Molecular Morphology, Department of Animal Science, Graduate School of Agricultural Science, Kobe University, Hyogo, Japan
| | - Ayano YOSHIMOTO
- Laboratory of Animal Molecular Morphology, Department of Animal Science, Graduate School of Agricultural Science, Kobe University, Hyogo, Japan
| | - Youhei MANTANI
- Laboratory of Histophysiology, Department of Animal Science, Graduate School of Agricultural Science, Kobe University, Hyogo, Japan
| | - Toshifumi YOKOYAMA
- Laboratory of Animal Molecular Morphology, Department of Animal Science, Graduate School of Agricultural Science, Kobe University, Hyogo, Japan
| | - Tetsushi HIRANO
- Faculty of Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Eiko MATSUO
- Laboratory of Microbiology and Immunology, Department of Animal Science, Graduate School of Agricultural Science, Kobe University, Hyogo, Japan
| | - Yoshinori IKENAKA
- Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
- Translational Research Unit, Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
- One Health Research Center, Hokkaido University, Hokkaido, Japan
- Water Research Group, Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
| | - Nobuhiko HOSHI
- Laboratory of Animal Molecular Morphology, Department of Animal Science, Graduate School of Agricultural Science, Kobe University, Hyogo, Japan
| |
Collapse
|
4
|
Saeki H, Kataoka Y, Etoh T, Katoh N, Teramukai S, Tajima Y, Fujita H, Ardeleanu M, Arima K. Correlation Analysis of Clinician- and Patient-Reported Outcomes Among Japanese Adults with Atopic Dermatitis. Dermatol Ther (Heidelb) 2024; 14:533-543. [PMID: 38326699 PMCID: PMC10890985 DOI: 10.1007/s13555-023-01094-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/21/2023] [Indexed: 02/09/2024] Open
Abstract
INTRODUCTION Atopic dermatitis (AD) is a chronic relapsing condition with high disease burden and impact on health-related quality of life (HRQoL). Correlations between clinician- and patient-reported outcomes tend to be poor, and limited data in Asian patients are available. METHODS ADDRESS-J was a prospective, non-interventional, longitudinal study that evaluated the real-world effectiveness and safety of AD treatment in Japanese adults (aged 20-59 years) with moderate-to-severe AD. Three clinician-reported AD severity outcomes (Investigator's Global Assessment, Eczema Area and Severity Index, and body surface area affected), three dermatological patient-reported outcomes (Patient-Oriented Eczema Measure, Dermatology Life Quality Index, and Worst Itch Numerical Rating Scale), and two general HRQoL patient-reported outcomes (5-dimension EuroQoL questionnaire and EuroQol Visual Analog Scale) were collected at baseline and every 3 months throughout the 24-month observation period. Four biomarkers were also analyzed when available (thymus and activation-regulated chemokine [TARC], lactate dehydrogenase [LDH], total immunoglobulin E [IgE], and peripheral blood eosinophil counts [PB EOS]). Spearman's correlation coefficients were calculated using all available pooled data from baseline through 24 months. RESULTS Correlations between the three clinician-reported outcomes were high/very high (Spearman's correlation coefficients 0.76-0.92); those between the three dermatological patient-reported outcomes were moderate (0.53-0.64), and those between the clinician-reported and dermatological patient-reported outcomes were low/moderate (0.37-0.51). Correlations between the general HRQoL patient-reported outcomes and the clinician-reported and dermatological patient-reported outcomes were negligible-moderate (0.26-0.60). Biomarker correlations with the clinician-reported and dermatological patient-reported outcomes were low/moderate for TARC and LDH (0.44-0.63), but negligible/low for PB EOS and total IgE (0.01-0.41). CONCLUSIONS These results show that clinician- and patient-reported outcomes do not necessarily correlate well in Japanese adults with AD. This highlights the importance of including patient-reported outcomes when assessing disease severity/impact, planning treatment, and assessing response to treatment. TRIAL REGISTRATION UMIN Clinical Trials Registry (UMIN-CTR) Identifier UMIN000022623.
Collapse
Affiliation(s)
- Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, 113-8602, Japan.
| | - Yoko Kataoka
- Department of Dermatology, Osaka Habikino Medical Center, Osaka, 583-8588, Japan
| | - Takafumi Etoh
- Atago Dermatology Clinic, Tokyo, 105-0012, Japan
- Department of Dermatology, Tokyo Teishin Hospital, Tokyo, 102-8798, Japan
| | - Norito Katoh
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Satoshi Teramukai
- Department of Biostatistics, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | | | | | | | | |
Collapse
|