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Traidl S, Hollstein MM, Kroeger N, Fischer S, Heratizadeh A, Heinrich L, Kind B, Siegels D, Abraham S, Schäfer T, Augustin M, Harder I, Pinter A, Schäkel K, Wollenberg A, Ertner K, Ramaker-Brunke J, Bong A, Quist S, Gorriahn-Maiterth H, Schenck F, Sticherling M, Effendy I, Schwarz B, Handrick C, Asmussen A, Weidinger S, Schmitt J, Werfel T. Obesity is linked to disease severity in moderate to severe atopic dermatitis-Data from the prospective observational TREATgermany registry. J Eur Acad Dermatol Venereol 2024. [PMID: 38661511 DOI: 10.1111/jdv.20042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/22/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND There are conflicting data on a potential association between obesity and atopic dermatitis (AD). The purpose of this study was to investigate the relationship between obesity and AD disease severity. METHODS Patients from the TREATgermany registry cohort were divided into three groups according to their body mass index (BMI). Due to low numbers, underweight patients (BMI <18.5 kg/m2) were excluded from the analysis. Physician- and patient-reported disease severity scores as well as additional phenotypic characteristics were evaluated for association with BMI. Generalized linear mixed models and multinomial logit models, respectively, were applied to investigate the association of BMI, age, sex and current systemic AD treatment with disease severity. RESULTS This study encompassed 1416 patients, of which 234 (16.5%) were obese (BMI ≥30 kg/m2). Obesity was associated with lower educational background and smoking. Otherwise, obese and non-obese AD patients had similar baseline characteristics. Increased BMI was associated with higher oSCORAD (adjusted β: 1.24, 95% CI: 1.05-1.46, p = 0.013) and Patient-oriented eczema measure (POEM) (adjusted β: 1.09, 95% CI: 1.01-1.17, p = 0.038). However, the absolute difference in the overall oSCORAD was small between obese and non-obese AD patients (Δ oSCORAD = 2.5). Allergic comorbidity was comparable between all three groups, with the exception of asthma which was more pronounced in obese patients (p < 0.001). DISCUSSION In this large and well-characterized AD patient cohort, obesity is significantly associated with physician- and patient-assessed measures of AD disease severity. However, the corresponding effect sizes were low and of questionable clinical relevance. The overall prevalence of obesity among the German AD patients was lower than in studies on other AD cohorts from different countries, which confirms previous research on the German population and suggests regional differences in the interdependence of AD and obesity prevalence.
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Affiliation(s)
- Stephan Traidl
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Moritz M Hollstein
- Department of Dermatology, Venereology and Allergology, University Medical Centre Göttingen, Göttingen, Germany
| | - Nadine Kroeger
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Sascha Fischer
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Annice Heratizadeh
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Luise Heinrich
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany
| | - Barbara Kind
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany
| | - Doreen Siegels
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany
| | - Susanne Abraham
- Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Thomas Schäfer
- Practice Dr. med. Thomas Schaefer/Dr. med. Doreen Belz, Derma Koeln, Koeln, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Inken Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Andreas Pinter
- Department of Dermatology, Venereology and Allergology, Clinical Research, University Hospital, Frankfurt am Main, Germany
| | - Knut Schäkel
- Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Andreas Wollenberg
- Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany
- Department of Dermatology and Allergy, University Hospital Augsburg, Augsburg, Germany
- Comprehensive Center for Inflammation Medicine, University of Luebeck, Luebeck, Germany
| | | | | | - Anne Bong
- Practice Dr. med. Anne Bong, Emmerich, Germany
| | - Sven Quist
- Dermatology Clinic, Helix Medical Excellence Center Mainz, Mainz, Germany
| | | | | | - Michael Sticherling
- Department of Dermatology, University, German Center for Immunotherapy, Erlangen, Germany
| | - Isaak Effendy
- Department of Dermatology Venereology and Allergology, University Hospital - Medical School OWL - University of Bielefeld, Rosenhoehe, Bielefeld, Germany
| | | | | | - Andrea Asmussen
- Practice Dr. med. Andrea Asmussen, Dermatology at Lesum, Bremen, Germany
| | - Stephan Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany
| | - Thomas Werfel
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
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Traidl S, Heinrich L, Siegels D, Rösner L, Haufe E, Harder I, Abraham S, Ertner K, Kleinheinz A, Schäkel K, Wollenberg A, Effendy I, Quist S, Asmussen A, Wildberger J, Weisshaar E, Wiemers F, Brücher JJ, Weidinger S, Schmitt J, Werfel T. High recurrence rate of eczema herpeticum in moderate/severe atopic dermatitis -TREATgermany registry analysis. J Dtsch Dermatol Ges 2023; 21:1490-1498. [PMID: 37814394 DOI: 10.1111/ddg.15205] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 07/09/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Eczema herpeticum (EH) is a disseminated skin infection caused by herpes simplex virus in atopic dermatitis (AD) patients. The frequency of EH and the clinical features of EH patients have not yet been investigated in a larger cohort. METHODS We sought to investigate the TREATgermany cohort, a multicenter, non-interventional clinical registry of moderately to severely affected AD patients in Germany. Baseline characteristics of patients included between December 2017 and April 2021 were compared between patients without, single, and multiple EH. RESULTS Of the 893 patients, 195 (21.8%) had at least one EH. Of the 195 patients with EH, 107 had multiple EH (54.9%), representing 12.0% of the total study population. While there were no differences in demographic characteristics, previous treatment, and disease scores at enrollment (itch, IGA, oSCORAD, EASI), patients with EH had more frequent atopic comorbidities and sensitizations to house dust mite, food, and mold. DISCUSSION TREATgermany registry data suggest a high prevalence and recurrence rate of EH, while there appears to be no specific clinical phenotype, besides an increase in allergies, to identify EH patients in the daily routine.
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Affiliation(s)
- Stephan Traidl
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
- Hannover Medical School, Cluster of Excellence RESIST (EXC 2155), Hannover, Germany
| | - Luise Heinrich
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Doreen Siegels
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Lennart Rösner
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
- Hannover Medical School, Cluster of Excellence RESIST (EXC 2155), Hannover, Germany
| | - Eva Haufe
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Inken Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Susanne Abraham
- Department of Dermatology, University Allergy Center, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | | | | | - Knut Schäkel
- Department of Dermatology, University Hospital, Heidelberg, Germany
| | - Andreas Wollenberg
- Department of Dermatology and Allergy, University Hospital Augsburg, Augsburg, Ludwig Maximilian University, Munich, Germany
| | - Isaak Effendy
- Department of Dermatology, OWL University Hospital of Bielefeld University, Campus Clinic Bielefeld, Bielefeld, Germany
| | - Sven Quist
- Dermatology Clinic, Helix Medical Ecellence Center Mainz, Mainz, Germany
| | - Andrea Asmussen
- Practice Dr. med. Andrea Asmussen, Dermatology at Lesum, Bremen, Germany
| | - Julia Wildberger
- Practice Dr. med. Julia Wildberger Hautmedizin, Bad Soden, Germany
| | - Elke Weisshaar
- Division of Occupational Dermatology, Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | | | - Jens-Joachim Brücher
- Practice Dr. med. Jens-Joachim Brücher, Hautambulatorium Magdeburg, Magdeburg, Germany
| | - Stephan Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Thomas Werfel
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
- Hannover Medical School, Cluster of Excellence RESIST (EXC 2155), Hannover, Germany
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Traidl S, Heinrich L, Siegels D, Rösner L, Haufe E, Harder I, Abraham S, Ertner K, Kleinheinz A, Schäkel K, Wollenberg A, Effendy I, Quist S, Asmussen A, Wildberger J, Weisshaar E, Wiemers F, Brücher JJ, Weidinger S, Schmitt J, Werfel T. Hohe Rezidivrate des Eczema herpeticatum bei mittelschwerer bis schwerer atopischer Dermatitis - eine TREATgermany Registeranalyse. J Dtsch Dermatol Ges 2023; 21:1490-1499. [PMID: 38082531 DOI: 10.1111/ddg.15205_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 07/09/2023] [Indexed: 12/18/2023]
Abstract
ZusammenfassungHintergrundDas Eczema herpeticatum (EH) ist eine disseminierte Hautinfektion, die durch Herpes‐simplex‐Viren bei Patienten mit atopischer Dermatitis (AD) verursacht wird. Die Häufigkeit des EH und die klinischen Charakteristika von EH Patienten wurden bisher noch nicht in einer größeren Kohorte untersucht.Methodik87 Patienten des TREATgermany Registers, einem multizentrischen, nichtinterventionellen klinischen Register mit moderat bis schwer betroffenen AD‐Patienten in Deutschland, wurden in dieser Analyse betrachtet. Patienten, die zwischen Dezember 2017 und April 2021 in das Register eingeschlossen wurden, wurden unterteilt in die Gruppen ohne, mit einem und mit mehreren EH und basierend auf den klinischen Charakteristika verglichen.ErgebnisseVon 893 Patienten berichteten 195 (21,8%) über mindestens eine EH. 107 der 195 Patienten mit EH hatten sogar mehrere EH in der Anamnese (54,9%), was 12,0% der gesamten Studienpopulation entspricht. Während hinsichtlich demographischer Merkmale, Vorbehandlungen und Krankheitsscores (Juckreiz, IGA, oSCORAD, EASI) keine Unterschiede festgestellt wurden, litten Patienten mit EH häufiger an atopischen Begleiterkrankungen und Sensibilisierungen gegen Hausstaubmilben, Nahrungsmittel und Schimmelpilze.SchlussfolgerungenDie Daten des TREATgermany‐Registers deuten auf eine hohe Prävalenz und Rezidivrate des EH hin, während es neben einer Häufung von Allergien keinen spezifischen klinischen Phänotyp zu geben scheint, um EH‐Patienten in der täglichen Routine zu identifizieren.
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Affiliation(s)
- Stephan Traidl
- Klinik für Dermatologie und Allergologie, Medizinische Hochschule Hannover, Hannover, Germany
- Medizinische Hochschule Hannover, Exzellenzcluster RESIST (EXC 2155), Hannover
| | - Luise Heinrich
- Zentrum für Evidenzbasierte Medizin, Universitätsklinikum Carl Gustav Carus und Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden
| | - Doreen Siegels
- Zentrum für Evidenzbasierte Medizin, Universitätsklinikum Carl Gustav Carus und Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden
| | - Lennart Rösner
- Klinik für Dermatologie und Allergologie, Medizinische Hochschule Hannover, Hannover, Germany
- Medizinische Hochschule Hannover, Exzellenzcluster RESIST (EXC 2155), Hannover
| | - Eva Haufe
- Zentrum für Evidenzbasierte Medizin, Universitätsklinikum Carl Gustav Carus und Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden
| | - Inken Harder
- Zentrum für entzündliche Hauterkrankungen, Klinik für Dermatologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Susanne Abraham
- Klinik für Dermatologie, Universitäts-Allergie-Centrum, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden
| | | | | | | | - Andreas Wollenberg
- Department of Dermatology and Allergy, University Hospital Augsburg, Augsburg, Ludwig Maximilian University, Munich, Germany
| | - Isaak Effendy
- Hautklinik, Universitätsklinikum OWL der Universität Bielefeld, Campus Klinikum Bielefeld
| | - Sven Quist
- Hautklinik, Helix Medical Ecellence Center Mainz
| | - Andrea Asmussen
- Praxis Dr. med. Andrea Asmussen, Hautarztpraxis an der Lesum, Bremen
| | | | - Elke Weisshaar
- Abteilung für Berufsdermatologie, Hautklinik, Ruprecht-Karls-Universität Heidelberg
| | | | | | - Stephan Weidinger
- Zentrum für entzündliche Hauterkrankungen, Klinik für Dermatologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Jochen Schmitt
- Zentrum für Evidenzbasierte Medizin, Universitätsklinikum Carl Gustav Carus und Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden
| | - Thomas Werfel
- Klinik für Dermatologie und Allergologie, Medizinische Hochschule Hannover, Hannover, Germany
- Medizinische Hochschule Hannover, Exzellenzcluster RESIST (EXC 2155), Hannover
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Birkner T, Siegels D, Heinrich L, Haufe E, Abraham S, Heratizadeh A, Harder I, Bell M, Fell I, Worm M, Handrick C, Effendy I, Asmussen A, Kleinheinz A, Homey B, Sticherling M, Hong-Weldemann SH, Augustin M, Weisshaar E, Schäkel K, Schaefer T, Schwarz B, Wiemers F, Brücher JJ, Quist S, Wollenberg A, Biedermann T, Ertner K, von Kiedrowski R, Werfel T, Weidinger S, Schmitt J. Itch, sleep loss, depressive symptoms, fatigue, and productivity loss in patients with moderate-to-severe atopic dermatitis: Analyses of TREATgermany registry data. J Dtsch Dermatol Ges 2023; 21:1157-1168. [PMID: 37485573 DOI: 10.1111/ddg.15159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/28/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND TREATgermany is a multicenter registry including patients with moderate-to-severe atopic dermatitis (AD) from currently 74 study centers (university clinics, hospitals and practices) in Germany. As of August 31, 2021, 1,230 adult patients were enrolled. METHODS In TREATgermany, patients and physicians fill in questionnaires pertaining to symptoms, disease severity, quality of life, depressiveness, and fatigue. In particular, limitations in work performance are assessed using the Work Limitations Questionnaire (WLQ). To assess associations between occupational performance/work limitations and symptoms, correlations and regression models were calculated. RESULTS The examined sample of 228 employed patients reported an average of 6% at-work productivity loss within the past two weeks prior to enrolment in the registry. The WLQ productivity loss score was moderately associated with itch (r = 0.32) and sleep loss (r = 0.39) and strongly associated with depressive symptoms (r = 0.68) and fatigue (r = 0.60). CONCLUSIONS The analyses of the registry data show that moderate-to-severe atopic dermatitis has a negative impact on the work productivity of the patients. The analyses further point out the relevant associations between work productivity, depressive symptoms, and fatigue highlighting the disease burden caused by the psychological components of AD.
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Affiliation(s)
- Thomas Birkner
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Doreen Siegels
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Luise Heinrich
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Eva Haufe
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susanne Abraham
- Department of Dermatology, University Allergy Center, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Annice Heratizadeh
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Inken Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Magnus Bell
- Practice Dr. med. Magnus Bell, Andernach, Germany
| | - Isabell Fell
- Hautmedizin Bad Soden Studienzentrum, Bad Soden, Germany
| | - Margitta Worm
- Department of Dermatology, Allergy and Venereology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Isaak Effendy
- Department of Dermatology, OWL University Hospital of Bielefeld University, Campus Clinic Bielefeld, Bielefeld, Germany
| | - Andrea Asmussen
- Practice Dr. med. Andrea Asmussen, Dermatology at Lesum, Bremen, Germany
| | | | - Bernhard Homey
- Department of Dermatology and Allergology, University Hospital Duesseldorf, Düsseldorf, Germany
| | - Michael Sticherling
- Department of Dermatology, University, German Center for Immunotherapy, Erlangen, Germany
| | | | - Matthias Augustin
- Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Elke Weisshaar
- Division of Occupational Dermatology, Department of Dermatology, Ruprecht-Karls University, Heidelberg, Germany
| | - Knut Schäkel
- Department of Dermatology, University Hospital, Heidelberg, Germany
| | - Thomas Schaefer
- Practice Dr. med. Thomas Schaefer/ Dr. med. Doreen Belz, Derma Koeln, Köln, Germany
| | | | | | - Jens-Joachim Brücher
- Practice Dr. med. Jens-Joachim Brücher, Hautambulatorium Magdeburg, Magdeburg, Germany
| | - Sven Quist
- Dermatology Clinic, Helix Medical Excellence Center Mainz, Mainz, Germany
| | - Andreas Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, München, Germany and Vrije Universiteit Brussel, Universitair Ziekenhuis, Department of Dermatology, Brussels, Belgium
| | - Tilo Biedermann
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, München, Germany
| | | | - Ralph von Kiedrowski
- Focus Practice for chronic inflammatory dermatoses, skin cancer and allergology and also Study Center CMS3 (Company for Medical Study and Service), Selters/Westerwald, Germany
| | - Thomas Werfel
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Stephan Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Jochen Schmitt
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Birkner T, Siegels D, Heinrich L, Haufe E, Abraham S, Heratizadeh A, Harder I, Bell M, Fell I, Worm M, Handrick C, Effendy I, Asmussen A, Kleinheinz A, Homey B, Sticherling M, Hong-Weldemann SH, Augustin M, Weisshaar E, Schäkel K, Schaefer T, Schwarz B, Wiemers F, Brücher JJ, Quist S, Wollenberg A, Biedermann T, Ertner K, von Kiedrowski R, Werfel T, Weidinger S, Schmitt J. Juckreiz, Schlafstörungen, depressive Symptome, Fatigue und Einschränkungen der Arbeitsproduktivität bei Patienten mit moderater bis schwerer atopischer Dermatitis: Daten aus dem TREATgermany-Register. J Dtsch Dermatol Ges 2023; 21:1157-1169. [PMID: 37845075 DOI: 10.1111/ddg.15159_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/28/2023] [Indexed: 10/18/2023]
Abstract
ZusammenfassungHintergrundTREATgermany ist ein multizentrisches Register, das Patienten mit moderater bis schwerer atopischer Dermatitis (AD) aus derzeit 74 Studienzentren (Universitätskliniken, Krankenhäuser und Praxen) in Deutschland umfasst. Bis zum 31. August 2021 wurden 1.230 erwachsene Patienten eingeschlossen.MethodenIn TREATgermany füllen Patienten und Ärzte Fragebögen zu Symptomen, Krankheitsschwere, Lebensqualität, Depressivität und Fatigue aus. Die Einschränkungen der Arbeitsleistung werden insbesondere mit dem Work Limitations Questionnaire (WLQ) erfasst. Um Assoziationen zwischen beruflicher Leistung/Arbeitseinschränkungen und Symptomen zu bestimmen, wurden Korrelationen und Regressionsmodelle berechnet.ErgebnisseDie untersuchte Stichprobe von 228 berufstätigen Patienten beschrieb einen durchschnittlichen Produktivitätsverlust von 6% bei der Arbeit innerhalb der letzten zwei Wochen vor der Aufnahme in das Register. Der WLQ‐Wert für den Produktivitätsverlust war moderat mit Juckreiz (r = 0,32) und Schlafstörungen (r = 0,39) und stark mit depressiven Symptomen (r = 0,68) und Fatigue (r = 0,60) korreliert.SchlussfolgerungenDie Analysen der Registerdaten zeigen, dass eine moderate bis schwere AD einen negativen Einfluss auf die Arbeitsproduktivität der Patienten hat. Die Analysen weisen außerdem auf die relevanten Zusammenhänge zwischen Arbeitsproduktivität, depressiven Symptomen und Fatigue hin, was die durch die psychologischen Komponenten der AD verursachte Krankheitslast verdeutlicht.
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Affiliation(s)
- Thomas Birkner
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Doreen Siegels
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Luise Heinrich
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Eva Haufe
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Susanne Abraham
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Annice Heratizadeh
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - Inken Harder
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | | | | | - Margitta Worm
- Klinik für Dermatologie, Venerologie und Allergologie am Campus Mitte (CCM), Charité - Universitätsmedizin Berlin
| | | | - Isaak Effendy
- Hautklinik, Universitätsklinikum OWL der Universität Bielefeld, Campus Klinikum Bielefeld
| | - Andrea Asmussen
- Praxis Dr. med. Andrea Asmussen, Dermatologie an der Lesum, Bremen
| | - Andreas Kleinheinz
- Klinik für Dermatologie, Allergologische Ambulanz, Elbe Klinikum Buxtehude
| | - Bernhard Homey
- Klinik für Dermatologie, Universitätsklinikum Düsseldorf
| | | | | | - Matthias Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - Elke Weisshaar
- Berufsdermatologie, Hautklinik, Universitätsklinikum Heidelberg
| | - Knut Schäkel
- Universitäts-Hautklinik, Universitätsklinikum Heidelberg
| | - Thomas Schaefer
- Praxis Dr. med. Thomas Schaefer/ Dr. med. Doreen Belz, Derma Köln
| | - Beate Schwarz
- Praxis Dr. med. Beate Schwarz, Dermatologie und Allergologie, Langenau
| | | | | | - Sven Quist
- Dermatologische Klinik, Helix Medical Excellence Center, Mainz
| | - Andreas Wollenberg
- Klinik und Poliklinik für Dermatologie und Allergologie, LMU München und Hautklinik, Vrije Universiteit Brussel, Universitair Ziekenhuis, Brüssel, Belgien
| | - Tilo Biedermann
- Klinik für Dermatologie und Allergologie, Klinikum rechts der Isar, Technischen Universität München
| | | | - Ralph von Kiedrowski
- Spezialpraxis für chronisch-entzündliche Dermatosen, Hautkrebs und Allergologie/Berufsdermatologie und Studienzentrums CMS3 (Company for Medical Study and Service), Selters/Westerwald
| | - Thomas Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - Stephan Weidinger
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Jochen Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
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6
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Hartmann J, Moitinho-Silva L, Sander N, Harder I, Häsler R, Rodriguez E, Haufe E, Kleinheinz A, Abraham S, Heratizadeh A, Weisshaar E, Schäkel K, Handrick C, Augustin M, Wollenberg A, Staubach-Renz P, Ertner K, Sticherling M, Schwarz B, Quist S, Wiemers F, Schenck F, Wildberger J, Tittmann L, Lieb W, Schmitt J, Werfel T, Weidinger S. Dupilumab but not cyclosporine treatment shifts the microbiome toward a healthy skin flora in patients with moderate-to-severe atopic dermatitis. Allergy 2023; 78:2290-2300. [PMID: 37032440 DOI: 10.1111/all.15742] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) patients display an altered skin microbiome which may not only be an indicator but also a driver of inflammation. We aimed to investigate associations among AD patients' skin microbiome, clinical data, and response to systemic therapy in patients of the TREATgermany registry. METHODS Skin swabs of 157 patients were profiled with 16S rRNA gene amplicon sequencing before and after 3 months of treatment with dupilumab or cyclosporine. For comparison, 16s microbiome data from 258 population-based healthy controls were used. Disease severity was assessed using established instruments such as the Eczema Area and Severity Index (EASI). RESULTS We confirmed the previously shown correlation of Staphylococcus aureus abundance and bacterial alpha diversity with AD severity as measured by EASI. Therapy with Dupilumab shifted the bacterial community toward the pattern seen in healthy controls. The relative abundance of Staphylococci and in particular S. aureus significantly decreased on both lesional and non-lesional skin, whereas the abundance of Staphylococcus hominis increased. These changes were largely independent from the degree of clinical improvement and were not observed for cyclosporine. CONCLUSIONS Systemic treatment with dupilumab but not cyclosporine tends to restore a healthy skin microbiome largely independent of the clinical response indicating potential effects of IL-4RA blockade on the microbiome.
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Affiliation(s)
- Jan Hartmann
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Lucas Moitinho-Silva
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
- Institute of Clinical Molecular Biology, Kiel University, Kiel, Germany
| | - Nicole Sander
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Inken Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Robert Häsler
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Elke Rodriguez
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Eva Haufe
- Center of Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | | | - Susanne Abraham
- Department of Dermatology, Medical Faculty Carl Gustav Carus, University Allergy Center, TU Dresden, Dresden, Germany
| | - Annice Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Elke Weisshaar
- Division of Occupational Dermatology, Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Knut Schäkel
- Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | | | - Matthias Augustin
- Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Andreas Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Munich, Germany
| | - Petra Staubach-Renz
- Department of Dermatology and Allergy, University Medical Center Mainz, Mainz, Germany
| | | | - Michael Sticherling
- Department of Dermatology, University Hospital, Friedrich Alexander University Erlangen-Nuernberg, Erlangen, Germany
| | | | - Sven Quist
- Dermatology Clinic, Helix Medical Excellence Center Mainz, Mainz, Germany
| | | | | | - Julia Wildberger
- Practice Dr. med. Julia Wildberger, Hautmedizin Bad Soden, Bad Soden, Germany
| | - Lukas Tittmann
- Biobank PopGen and Institute of Epidemiology, Kiel University, Kiel, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology, Kiel University, Kiel, Germany
| | - Jochen Schmitt
- Center of Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Stephan Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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7
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Weisshaar E, Bentz P, Haufe E, Heinrich L, Apfelbacher C, Heratizadeh A, Abraham S, Harder I, Kleinheinz A, Wollenberg A, Schäkel K, Wiemers F, Ertner K, Augustin M, Wildberger J, von Kiedrowski R, Worm M, Zink A, Effendy I, Asmussen A, Pawlak M, Sticherling M, Hilgers M, Handrick C, Quist S, Schwarz B, Bell M, Staubach-Renz P, Hong-Weldemann SH, Homey B, Bruecher J, Weidinger S, Werfel T, Schmitt J. Itching and treatments in atopic dermatitis (AD): results from the German AD registry TREATgermany. Br J Dermatol 2023; 188:430-432. [PMID: 36763757 DOI: 10.1093/bjd/ljac070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/21/2022] [Accepted: 11/15/2022] [Indexed: 01/22/2023]
Affiliation(s)
- Elke Weisshaar
- Occupational Dermatology, Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - Philipp Bentz
- Occupational Dermatology, Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - Eva Haufe
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Germany
| | - Luise Heinrich
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Germany
| | - Christian Apfelbacher
- Institute for Epidemiology and Preventive Medicine/Medical Sociology, University of Regensburg, Regensburg, Germany.,Institute of Social Medicine and Health Systems Research, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Annice Heratizadeh
- Department of Dermatology, Allergy and Venerology, Hannover Medical School, Germany
| | - Susanne Abraham
- Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, TU Dresden, Germany
| | - Inken Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Andreas Kleinheinz
- Clinics for Dermatology, Elbe Klinikum Buxtehude, Germany.,Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Germany
| | - Andreas Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Germany
| | - Knut Schäkel
- Department of Dermatology, University of Heidelberg, Germany
| | | | | | - Matthias Augustin
- Institute for Health Research in Dermatology, University Medical Center Hamburg, Germany
| | | | | | - Margitta Worm
- Clinics for Dermatology, Venerology and Allergy, Charité Berlin, Germany
| | - Alexander Zink
- Department of Dermatology and Allergy, Technical University of Munich, Germany
| | - Isaak Effendy
- Department of Dermatology and Allergology, Campus Bielefeld, University OWL, Germany
| | | | - Mario Pawlak
- Private Practice Dr. Anika Hünermund, Mario Pawlak, Heilbad Heiligenstadt, Germany
| | | | - Melanie Hilgers
- Clinics for Dermatology and Allergy, University Hospital Aachen, Germany
| | | | - Sven Quist
- Dermatology Clinic, Helix Medical Ecellence Center, Mainz, Germany
| | - Beate Schwarz
- Private Practice Dr. Beate Schwarz, Langenau, Germany
| | - Magnus Bell
- Private Practice Dr. Magnus Bell, Andernach, Germany
| | - Petra Staubach-Renz
- Department of Dermatology and Allergy, University Medical Center Mainz, Germany
| | | | - Bernhard Homey
- Department of Dermatology, University of Duesseldorf, Germany
| | | | - Stephan Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Thomas Werfel
- Department of Dermatology, Allergy and Venerology, Hannover Medical School, Germany
| | - Jochen Schmitt
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Germany
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8
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Augustin M, Bauer A, Ertner K, von Kiedrowski R, Schenck F, Ramaker-Brunke J, Möller S, Fait A, Bastian M, Thaçi D. Dupilumab Demonstrates Rapid Onset of Action in Improving Signs, Symptoms and Quality of Life in Adults with Atopic Dermatitis. Dermatol Ther (Heidelb) 2023; 13:803-816. [PMID: 36738405 PMCID: PMC9984619 DOI: 10.1007/s13555-023-00894-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Dupilumab has significantly improved the signs, symptoms and quality of life (QoL) of patients with moderate-to-severe atopic dermatitis (AD) in randomised, controlled clinical trials. However, there is a need to assess the effectiveness and safety of dupilumab in real-world clinical practice. The PROLEAD study was designed to examine the effectiveness and safety of dupilumab in moderate-to-severe AD in a real-world setting in Germany. Here, we present 12-week effectiveness and safety results with dupilumab from PROLEAD. METHODS PROLEAD is a multicentre, prospective, non-interventional study being conducted at 126 routine care sites across Germany. Adults with moderate-to-severe AD who require systemic therapy were treated with dupilumab as indicated by the Summary of Product Characteristics. Data collected included physician assessments (EASI, BSA, SCORAD, and IGA) and patient-reported outcomes (PROs [POEM, DLQI, EQ-5D-5L, Peak Pruritus NRS and MOS Sleep Scale]). RESULTS Of 839 patients assessed for eligibility, 828 were included. The full analysis and safety analysis sets comprised 775 and 818 patients, respectively. The number of patients receiving concomitant therapy decreased from baseline to Week 12. Mean (standard deviation [SD]) percentage change in EASI score from baseline to Week 12 was -67.5% (48.4%) and was comparable across the four body regions. The proportion of patients achieving EASI-75 was 59.4% at Week 12. Mean (SD) Peak Pruritus NRS decreased from 7.4 (2.3) at baseline to 3.4 (2.6) at Week 12. Improvements from baseline to Week 12 were reported in all PROs assessed. No new safety signals were observed. DISCUSSION Improvements in efficacy outcomes and adverse event rates in a real-world setting were more favourable than in phase 3 clinical trials. CONCLUSIONS The 12-week findings of PROLEAD demonstrate that treatment with dupilumab is effective and well tolerated, with rapid onset of action in signs, symptoms and QoL in patients with moderate-to-severe AD in the real world. TRIAL REGISTRATION NUMBER DUPILL08907; NIS-Nr. 433.
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Affiliation(s)
- Matthias Augustin
- Institute of Health Care Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andrea Bauer
- Department of Dermatology, University Allergy Centre, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | | | - Ralph von Kiedrowski
- Company for Medical Study and Service Selters, GmbH and Dermatology Practice Dr von Kiedrowski, Selters (Westerwald), Germany
| | | | | | | | | | | | - Diamant Thaçi
- Institute and Comprehensive Center Inflammation Medicine, University of Lübeck, Lübeck, Germany
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9
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Stölzl D, Sander N, Heratizadeh A, Haufe E, Harder I, Abraham S, Heinrich L, Kleinheinz A, Wollenberg A, Weisshaar E, Schäkel K, Ertner K, Wiemers F, Wildberger J, Worm M, von Kiedrowski R, Effendy I, Asmussen A, Augustin M, Pawlak M, Sticherling M, Zink A, Hilgers M, Handrick C, Quist S, Schwarz B, Staubach-Renz P, Bell M, Hong-Weldemann SH, Homey B, Brücher JJ, Schmitt J, Werfel T, Weidinger S. Real-world data on the effectiveness, safety and drug survival of dupilumab: an analysis from the TREATgermany registry. Br J Dermatol 2022; 187:1022-1024. [PMID: 35895855 DOI: 10.1111/bjd.21794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/22/2022] [Accepted: 07/22/2022] [Indexed: 12/24/2022]
Abstract
This interim analysis from the atopic dermatitis registry TREATgermany shows robust long-term efficacy, favourable safety and high persistence of dupilumab under real life conditions.
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Affiliation(s)
- Dora Stölzl
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Nicole Sander
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Annice Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Eva Haufe
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Inken Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Susanne Abraham
- Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, TU Dresden, Germany
| | - Luise Heinrich
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | | | - Andreas Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Germany
| | - Elke Weisshaar
- Occupational Dermatology, Department of Dermatology, Ruprecht-Karls University Heidelberg, Germany
| | - Knut Schäkel
- Department of Dermatology, Ruprecht-Karls University Heidelberg, Germany
| | | | | | - Julia Wildberger
- Practice Dr. med. Julia Wildberger, Hautmedizin, Bad Soden, Germany
| | - Margitta Worm
- Clinics for Dermatology, Venerology and Allergy, Charité Berlin, Germany
| | | | - Isaak Effendy
- Department of Dermatology, Hospital Rosenhoehe, Bielefeld, Germany
| | - Andrea Asmussen
- Practice Dr. med. Andrea Asmussen, Dermatology at Lesum, Bremen, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg-Eppendorf, Germany
| | - Mario Pawlak
- Practice Dr. med. Anika Hünermund and Mario Pawlak, Heilbad Heiligenstadt, Germany
| | - Michael Sticherling
- Department of Dermatology, University Hospital, Friedrich-Alexander-University Erlangen-Nuernberg, Germany
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich and Clinical Unit Allergology, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, Germany
| | - Melanie Hilgers
- Clinics for Dermatology and Allergy, University Hospital Aachen, Germany
| | | | - Sven Quist
- Dermatology Clinic, Helix Medical Excellence Center Mainz, Germany
| | | | - Petra Staubach-Renz
- Department of Dermatology and Allergy, University Medical Center Mainz, Germany
| | - Magnus Bell
- Practice Dr. med. Magnus Bell, Thomas Kaiser, Andernach, Germany
| | | | - Bernhard Homey
- Department of Dermatology, Heinrich-Heine-University Duesseldorf, Germany
| | | | - Jochen Schmitt
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Stephan Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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10
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Augustin M, Landeck L, Diemert S, Asadullah K, Hammann U, Ertner K, Hadshiew I. Long-Term Treatment with Dimethyl Fumarate for Plaque Psoriasis in Routine Practice: Good Overall Effectiveness and Positive Effect on Impactful Areas. Dermatol Ther (Heidelb) 2022; 12:1121-1131. [PMID: 35403945 PMCID: PMC8995418 DOI: 10.1007/s13555-022-00714-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/17/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction Dimethyl fumarate (DMF) is an oral compound to treat plaque psoriasis. Data on the treatment of patients with psoriasis affecting impactful areas are scarce. In this interim analysis of the prospective, noninterventional SKILL study, we summarized results of DMF treatment regarding effectiveness (overall and in impactful areas) and safety. Methods Data from 676 patients suffering from moderate-to-severe plaque psoriasis were analyzed after 52 weeks of DMF treatment. Of these, 257 had data available after 52 weeks. The considered impactful areas were nails, palms, soles, and scalp. Data analysis included observed cases (OC) and last observation carried forward (LOCF). Results All effectiveness parameters improved after 52 weeks. The Psoriasis Area and Severity Index score was reduced by 79.5% (OC) and 65.7% (LOCF). Compared with baseline, improvements were shown for 70.2% of the patients in their nail psoriasis [nail-Physician Global Assessment (PGA)] and for 57.3% in palmoplantar disease (palmoplantar-PGA). The proportion of patients with scalp-PGA 0/1 (clear/almost clear) increased significantly to 79.8% (OC) and 69.3% (LOCF, both p < 0.001) (versus 37.5% and 36.6% at baseline, respectively). Significant reduction of pruritus (p < 0.001) was also observed. No unexpected adverse drug reactions were observed. Conclusion Long-term treatment with DMF in routine practice showed good overall effectiveness and safety, and a positive effect on plaque-psoriasis-affected impactful areas. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-022-00714-0.
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Affiliation(s)
- Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany.
| | - Lilla Landeck
- Ernst von Bergmann General Hospital, Potsdam, Germany
| | | | - Khusru Asadullah
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Hautarztpraxis Prof. Dr. Med. K. Asadullah, Potsdam, Germany
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11
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Heinrich L, Haufe E, Abraham S, Heratizadeh A, Harder I, Kleinheinz A, Wollenberg A, Weisshaar E, Wiemers F, Ertner K, Schäkel K, Augustin M, Wildberger J, von Kiedrowski R, Zink A, Pawlak M, Worm M, Sticherling M, Effendy I, Hilgers M, Quist S, Asmussen A, Handrick C, Bell M, Staubauch-Renz P, Schwarz B, Hong-Weldemann SH, Homey B, Werfel T, Weidinger S, Schmitt J. Einschätzung der Erkrankungsschwere der Neurodermitis durch Ärzte und Patienten in Abhängigkeit vom Geschlecht: Ergebnisse aus dem Deutschen Neurodermitisregister TREATgermany+. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- L Heinrich
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, TU Dresden
| | - E Haufe
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, TU Dresden
| | - S Abraham
- Universitäts AllergieCentrum Dresden, Klinik für Dermatologie, Universitätsklinikum Carl Gustav Carus
| | - A Heratizadeh
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - I Harder
- Zentrum für Entzündliche Hauterkrankungen, Klinik für Dermatologie und Allergologie, Universitäts-klinikum Schleswig-Holstein, Campus Kiel
| | | | - A Wollenberg
- Klinik und Poliklinik für Dermatologie und Allergologie, LMU München
| | - E Weisshaar
- Berufsdermatologie, Klinik für Dermatologie, Universität Heidelberg
| | - F Wiemers
- Praxis Dr. Ulrike Wiemers/Dr. Franca Wiemers
| | | | - K Schäkel
- Klinik für Dermatologie, Universität Heidelberg
| | - M Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf
| | | | | | - A Zink
- Klinik für Dermatologie und Allergologie, TU München & Zentrum für Umweltmedizin GmbH
| | - M Pawlak
- Praxis Dr. Anika Hünermund, Mario Pawlak
| | - M Worm
- Klinik für Dermatologie, Venerologie und Allergologie, Charité Berlin
| | - M Sticherling
- Klinik für Dermatologie, Universität Erlangen-Nürnberg
| | - I Effendy
- Klinik für Dermatologie, Klinikum Rosenhöhe
| | - M Hilgers
- Universitätsklinikum Aachen, Uniklinik RWTH Aachen
| | | | - A Asmussen
- Praxis Dr. Andrea Asmussen, Dermatologie an der Lesum
| | | | - M Bell
- Praxis Dr. Magnus Bell, Thomas Kaiser
| | - P Staubauch-Renz
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Mainz
| | | | | | - B Homey
- Klinik für Dermatologie, Universität Düsseldorf
| | - T Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - S Weidinger
- Zentrum für Entzündliche Hauterkrankungen, Klinik für Dermatologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - J Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, TU Dresden
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