As Nurses you are aware that atopic dermatitis is a disease with a global scope. It can affect patients of all ages in developed and developing countries. It is often a persistent, lifelong disease with implications for global health issues. The prevalence of atopic dermatitis in adults is similar in Australia and the US, with 1-year prevalence rates of 6.9% and 7.2%, respectively. Severe atopic dermatitis is a burdensome disease which impacts the quality of life of patients and carers. Patients can be socially isolated, functionally unable to participate in school and workplace activities and can suffer from secondary bacterial and viral infections.’
The following contains some key points from the research review education series which is enclosed for your information.
‘A 2018 edition of Research Review contains a summary of a Symposium presented by Dr Mark Boguniewicz recently at the Gold Coast.
A recent analysis of patient-reported outcomes from 380 moderate-to-severe atopic dermatitis patients helped to define the burden of the disease
• ‘41% of patients had atopic dermatitis for less than 5 years and 37% were diagnosed 20 or more years ago
• 40% of patients also had asthma and 61% had other allergic conditions
• Despite almost half (48%) of the patients using systemic therapies in the past year, many patients still reported problems with itch frequency (85% of patients), itch duration (42% reported itching for 18 hours or more each day), and itch severity (55% of patients reporting sleep disturbances for 5 or more days per week)
• 22% of patients may have been suffering from anxiety or depression.’
‘Atopic dermatitis is most likely a systemic disease, suggesting that systemic treatment could be an important strategy for disease control
• Moderate-to-severe atopic dermatitis may be considered when there is a minimum involvement of 10% body surface area, or if the patient has lesions with moderate-to-severe features or the lesions are in highly visible areas or areas important for function, or if the patient has a significantly impaired quality of life
• Treatment failure may be defined as failure to achieve stable long-term disease control, inadequate clinical improvement, presence of ongoing impairment while on treatment, or unacceptable adverse events. There is no typical time to treatment failure for topical treatments and if failure is suspected, patient adherence should be assessed
• Dupilumab is recommended as a first-line systemic treatment option for adults with moderate-to-severe atopic dermatitis whose disease is not controlled by topical therapies. Prior to the approval of dupilumab , cyclosporin A was the only approved systemic treatment of atopic dermatitis in Australia.
• When choosing a therapy for moderate-to-severe atopic dermatitis patients, it is important to include the patient in the decision-making process. ‘
Research Review Australia provides clinical research updates. Covering top 10 research studies with commentary by well-known Australian experts. They are a great tool to help nurses keep up to date. Reviews are sent by email and cost nothing to subscribe. Subscribe online at www.researchreview.com.au or send an email to Trish (our database administrator) [email protected]” To download your copy login into your Research Review account. You can register for an account at www.researchreview.com.au or send an email to Trish (our database administrator) [email protected]