Inadequate Disease Control More Common With Moderate to Severe AD


atopic dermatitis

Inadequate control of atopic dermatitis (AD) was common among patients with moderate to severe disease and was associated with greater disease burden, according to the findings of a recent study. 

The cross-sectional study included 1519 participants with AD enrolled in 6 academic medical centers in the US. Participants were stratified by AD severity as mild (n=689) or moderate to severe (n=830) using the Patient-Oriented Scoring Atopic Dermatitis (PR-SCORAD). Additionally, participants with moderate to severe AD receiving systemic immunomodulators and/or phototherapy were categorized as having adequate or inadequate disease control.

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Validated measures and stand-alone questions that assessed itch, pain, sleep, anxiety and depression, and health-related quality of life were used to assess patient-reported burden of AD and disease control, which were compared between groups.  

Compared with participants with mild AD, those with moderate to severe AD reported more severe itching and pain, greater adverse effects on sleep, higher prevalence of anxiety and depression, and greater impairment in health-related quality of life.  

A total of 103 participants with moderate to severe AD had inadequate disease control despite treatment with systemic immunomodulators or phototherapy. They reported higher burdens of itch and sleep symptoms compared with those with controlled disease. Participants with inadequately controlled AD despite treatment experienced itchy skin on more days during the week and a higher proportion experienced itch that lasted more than half a day. In addition, trouble sleeping, more frequent sleep disturbances, and greater need for over-the-counter sleep medications were reported by more participants with inadequately controlled AD compared with those with disease control.  

“For patients with moderate to severe dermatitis, there is a need for more effective therapies and for greater incorporation of the patient’s perspective into clinical assessment,” the researchers concluded.


Simpson EL, Guttman-Yassky E, Margolis DJ, et al. Association of inadequately controlled disease and disease severity with patient-reported disease burden in adults with atopic dermatitis [Published online July 03, 2018]. JAMA Dermatol. doi:10.1001/jamadermatol.2018.1572.