Patient-Reported Outcomes

The voice of the atopic dermatitis (AD) patient is important in determining their true disease burden

Sleep

DLQI

Emotional State

Improved sleep scores were observed with less itch and clearer skin^1,2

Even with 90%-100% clearer skin, itch can still impact an AD patient's sleep scores^1,2*

Proportion of patients achieving ideal state sleep scores (0-3) at Week 16.^† Post hoc, integrated analysis of observed cases.

The percentage of patients who achieved ideal state sleep scores (0-3) with EASI 75 - <90 responses at Week 16 is 48%, and 72% in patients with EASI 90-100 responses. Of those patients who achieved EASI 90-100, 97% achieved ideal sleep state scores with WP-NRS 0-1 improvement, and 49% with WP-NRS 2-3.

*Domain scores for sleep and emotional state calculated as part of ADerm-IS.

^†Data include patients from three phase 3 studies at Week 16 in placebo and treatment groups.

Limitations¹

These are descriptive, observational, post hoc analyses; no statistical significance or conclusions can be drawn from these analyses
These PROs used questionnaires to ask patients to self-report their symptoms and impact in relation to their AD; factors not included in these PROs or not directly related to AD may confound these results
EASI data excludes 937 patients who did not achieve EASI 75 and WP-NRS data excludes 166 patients with WP-NRS ≥4

Calculations of the percent of patients achieving response were based on available data for each outcome. Sample sizes may vary depending on data availability of the measures involved.

Ask your patients how their disease is truly impacting them

It's important to look beyond rash alone. Itch may also impact your patients' sleep, DLQI, and emotional state scores.¹

Clearer skin alone may not be enough

WP-NRS 0-1
No to little itch²

EASI 90-100
Almost clear to clear skin⁴

Improved DLQI scores were observed with less itch and clearer skin^1,2

Even with 90%-100% clearer skin, itch can still impact an AD patient's quality of life^1,2*

Proportion of patients achieving ideal state DLQI scores (0-1) at Week 16.* Post hoc, integrated analysis of observed cases.

The percentage of patients who achieved ideal state sleep scores (0-3) with EASI 75 - <90 responses at Week 16 is 16%, and 51% in patients with EASI 90-100 responses. Of those patients who achieved EASI 90-100, 73% achieved ideal sleep state scores with WP-NRS 0-1 improvement, and 23% with WP-NRS 2-3.

*Data include patients from three phase 3 studies at Week 16 in placebo and treatment groups.

Limitations¹

These are descriptive, observational, post hoc analyses; no statistical significance or conclusions can be drawn from these analyses
These PROs used questionnaires to ask patients to self-report their symptoms and impact in relation to their AD; factors not included in these PROs or not directly related to AD may confound these results
EASI data excludes 937 patients who did not achieve EASI 75 and WP-NRS data excludes 166 patients with WP-NRS ≥4

Calculations of the percent of patients achieving response were based on available data for each outcome. Sample sizes may vary depending on data availability of the measures involved.

Ask your patients how their disease is truly impacting them

It's important to look beyond rash alone. Itch may also impact your patients' sleep, DLQI, and emotional state scores.¹

Clearer skin alone may not be enough

WP-NRS 0-1
No to little itch²

EASI 90-100
Almost clear to clear skin⁴

Improved emotional state scores were observed with less itch and clearer skin^1,2

Even with 90%-100% clearer skin, itch can still impact an AD patient's emotional scores^1,2*

Proportion of patients achieving ideal state emotional state scores (0-2) at Week 16.^† Post hoc, integrated analysis of observed cases.

The percentage of patients who achieved ideal state emotional state scores (0-2) with EASI 75 - <90 responses at Week 16 is 44%, and 68% in patients with EASI 90-100 responses. Of those patients who achieved EASI 90-100, 89% achieved ideal sleep state scores with WP-NRS 0-1 improvement, and 50% with WP-NRS 2-3.

*Domain scores for sleep and emotional state calculated as part of ADerm-IS.

^†Data include patients from three phase 3 studies at Week 16 in placebo and treatment groups.

Limitations¹

These are descriptive, observational, post hoc analyses; no statistical significance or conclusions can be drawn from these analyses
These PROs used questionnaires to ask patients to self-report their symptoms and impact in relation to their AD; factors not included in these PROs or not directly related to AD may confound these results
EASI data excludes 937 patients who did not achieve EASI 75 and WP-NRS data excludes 166 patients with WP-NRS ≥4

Calculations of the percent of patients achieving response were based on available data for each outcome. Sample sizes may vary depending on data availability of the measures involved.

Ask your patients how their disease is truly impacting them

It's important to look beyond rash alone. Itch may also impact your patients' sleep, DLQI, and emotional state scores.¹

Clearer skin alone may not be enough

WP-NRS 0-1
No to little itch²

EASI 90-100
Almost clear to clear skin⁴

Explore additional PRO data on the role of itch
resolution and skin clearance in AD and quality
of life by Target RWE.

Hear how Dr. Seminara assesses AD among her patients

Dr. Seminara discusses the importance of thoroughly assessing AD patients’ symptoms (even if they seem under control) and having experiences interacting with family and patients with AD. There are many challenges to assessing AD.

“When I’m assessing itch, sometimes it’s very obvious, but sometimes it’s much less obvious. If they’re experiencing persistent itch, even if they’re on systemic therapy, their disease may not be well controlled.”

– Dr. Seminara

Transcript

IDENTIFYING UNCONTROLLED atopic dermatitis

My name is Dr. Nicole Seminara. I studied at the University of Pennsylvania. I completed my dermatology residency at Stanford University. I then went on to be a faculty member at NYU, and I now work in the Charlotte area.

I treat probably 100 atopic dermatitis patients in an average month, and I have a great breadth of experience treating this patient population, and it’s a condition that I really love treating and feel very passionately about.

A PERSONAL CONNECTION with atopic dermatitis

I have a unique experience as a dermatologist in that a very close family member of mine suffers from severe atopic dermatitis.

Growing up with someone who suffers from this disease has given me a lot of insights into the unique challenges this patient population has to navigate on a daily basis.

CHALLENGES TO TREATING PATIENTS with atopic dermatitis

Atopic dermatitis presents differently in different patients.

We know the impact that it can have on patients’ skin, but one of the most challenging aspects of the disease is the itch.

Published studies have shown that almost 9 out of 10 moderate to severe atopic dermatitis patients experience itch every single day. And almost two thirds of those patients are experiencing itch for over 12 hours a day,¹ which for them can be unbearable.²

In my patients, I've had them tell me that they've had difficulty concealing their symptoms from other people, that they felt embarrassed that they need to cover their skin.

It's a disease that they literally have to wear every single day.

I've seen firsthand what it's like to live with atopic dermatitis. Having this experience has impacted the way I assess my atopic dermatitis patients.

It's easy for us to assess their rash, but to have a holistic view of the disease, we also need to assess their burden of itch.

ASSESSING THE DISEASE atopic dermatitis

The way I assess an atopic dermatitis patient in my practice is trying to figure out how much this is affecting their life.

Are they bleeding on their clothes? Are they conscious of how they may look to others? Are they scratching throughout the night? Is this something just running in the background, or does it have an impact on their life?

When I'm assessing itch in the office, sometimes it's very obvious. You can see the patient literally scratching in front of you. They're covered in excoriations. They have blood on their clothes.

Sometimes it's much less obvious. The patient might have very intact skin. They might not be scratching in front of you. Maybe they have excellent self-control, or maybe it itches in different times and different ways.

We can ask our patients to rate their itch from 1 to 10, and if they're experiencing persistent itch, even if they're on systemic therapy, their disease may not be well controlled.

GO BEYOND the surface level questions

I don't wait for a patient to tell me that they want more from their systemic treatment. Many of these patients have had atopic dermatitis their entire life. And on treatment, this may be the best they’ve ever felt, but that doesn't mean that they're well-controlled.

We should still assess them the same way we would look at a new or treatment-naive patient to determine if it may be time to consider other options.

In my opinion, it's important for all of us as clinicians to go beyond the surface-level questions.

We need to ask about itch. We need to assess the rash. We need to ask them if their symptoms are uncontrolled, and we need to ensure that we're providing them with the opportunity to explore other treatment options that may be able to help.

Starting the conversation about symptom control

Even if your patients are showing skin clearance, it's important to ask if AD is affecting them in ways that aren't readily visible. See how addressing the complexity of AD and its many pathways can make a difference for your patients who are itching for change.

Explore mechanism of disease

When it comes to their symptoms, some AD patients may not realize control is possible. Now is the time to discuss all the treatment options currently available to see which is right for them.

See AD treatment options

ADerm-IS=Atopic Dermatitis Impact Scale; ADerm-SS=Atopic Dermatitis Symptom Scale; DLQI=Dermatology Life Quality Index; EASI=Eczema Area and Severity Index; ITT=intention to treat; OC=observed cases; RWE=real-world evidence; TCS=topical corticosteroid; WP-NRS=Worst Pruritus Numerical Rating Scale.

REFERENCES:

Data on File. ABVRRTI75191.
Silverberg JI, Simpson EL, Calimlim BM, et al. Determining severity strata for three atopic dermatitis patient-reported outcome questionnaires: defining severity score ranges for the Worst Pruritus Numerical Rating Scale and the Atopic Dermatitis Symptom and Impact Scales (ADerm-SS and ADerm-IS). Dermatol Ther (Heidelb). 2022;12(12):2817-2827. doi:10.1007/s13555-022-00836-5
Guttman-Yassky E, Teixeira HD, Simpson EL, et al. Once-daily upadacitinib versus placebo in adolescents and adults with moderate-to-severe atopic dermatitis (Measure Up 1 and Measure Up 2): results from two replicate double-blind, randomised controlled phase 3 trials. Lancet. 2021;397(10290):2151-2168. doi:10.1016/S0140-6736(21)00588-2
Reich K, Teixeira HD, de Bruin-Weller M, et al. Safety and efficacy of upadacitinib in combination with topical corticosteroids in adolescents and adults with moderate-to-severe atopic dermatitis (AD Up): results from a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2021;397(10290):2169-2181. doi:10.1016/S0140-6736(21)00589-4
Silverberg JI, Thyssen JP, Costanzo A, et al. The multidimensional burden of moderate to severe atopic dermatitis: a pooled analysis of baseline data from three phase 3 studies (Measure Up 1, Measure Up 2, and AD Up). Poster presented at: 2021 Revolutionizing Atopic Dermatitis (RAD) Virtual Conference; June 13, 2021.
Hongbo Y, Thomas CL, Harrison MA, Salek MS, Finlay AY. Translating the science of quality of life into practice: what do Dermatology Life Quality Index scores mean? J Invest Dermatol. 2005;125(4):659-664. doi:10.1111/j.0022-202X.2005.23621.x

Patient-Reported Outcomes

The voice of the atopic dermatitis (AD) patient is important in determining their true disease burden

Improved sleep scores were observed with less itch and clearer skin1,2

Even with 90%-100% clearer skin, itch can still impact an AD patient's sleep scores1,2*

Limitations1

Ask your patients how their disease is truly impacting them

Clearer skin alone may not be enough

Improved DLQI scores were observed with less itch and clearer skin1,2

Even with 90%-100% clearer skin, itch can still impact an AD patient's quality of life1,2*

Limitations1

Ask your patients how their disease is truly impacting them

Clearer skin alone may not be enough

Improved emotional state scores were observed with less itch and clearer skin1,2

Even with 90%-100% clearer skin, itch can still impact an AD patient's emotional scores1,2*

Limitations1

Ask your patients how their disease is truly impacting them

Clearer skin alone may not be enough

Hear how Dr. Seminara assesses AD among her patients

Starting the conversation about symptom control

Improved sleep scores were observed with less itch and clearer skin^1,2

Even with 90%-100% clearer skin, itch can still impact an AD patient's sleep scores^1,2*

Limitations¹

Improved DLQI scores were observed with less itch and clearer skin^1,2

Even with 90%-100% clearer skin, itch can still impact an AD patient's quality of life^1,2*

Limitations¹

Improved emotional state scores were observed with less itch and clearer skin^1,2

Even with 90%-100% clearer skin, itch can still impact an AD patient's emotional scores^1,2*

Limitations¹