TY - JOUR
T1 - Pain Is a Common and Burdensome Symptom of Atopic Dermatitis in United States Adults
AU - Silverberg, Jonathan I.
AU - Gelfand, Joel M.
AU - Margolis, David J.
AU - Boguniewicz, Mark
AU - Fonacier, Luz
AU - Grayson, Mitchell H.
AU - Chiesa Fuxench, Zelma C.
AU - Simpson, Eric L.
AU - Ong, Peck Y.
N1 - Funding Information:
Atopic Dermatitis in America Study is an independent research project of the Asthma and Allergy Foundation of America in partnership with the National Eczema Association (NEA) and sponsored by Sanofi Genzyme and Regeneron.Conflicts of interest: J. I. Silverberg served as a consultant and/or advisory board member for AbbVie, AnaptysBio, Asana, Arena, Boehringer Ingelheim, Dermavant, Eli Lilly, Galderma, GlaxoSmithKline, Glenmark, Kiniksa, Leo, Menlo, Novartis, Pfizer, Regeneron-Sanofi, Realm receiving honoraria; speaker for Regeneron-Sanofi; and received research grants from GlaxoSmithKline. J. M. Gelfand served as a consultant for Bristol-Myers Squibb, Boehringer Ingelheim, Janssen Biologics, Novartis Corp, UCB (DSMB), Sanofi, and Pfizer Inc., and receives grants (to the Trustees of the University of Pennsylvania) from AbbVie, Janssen, Novartis Corp, Sanofi, Celgene, Ortho Dermatologics, and Pfizer Inc. D. J. Margolis is the chair of the data monitoring committee for all Sunovion clinical trials of Dupilumab, and has received independent research funding to his institution from the National Institute of Health and Valeant and is a consultant for Pfizer. M. Boguniewicz has received research funding from Regeneron and consulted for Regeneron, Sanofi-Genzyme, and Eli Lilly. L. Fonacier has served as a consultant for Regeneron, receiving honoraria; and received research and educational grants from Genentech, Regeneron, Baxter, and Pfizer. M. H. Grayson is a board member of Asthma and Allergy Foundation of America and chair for the Asthma and Allergy Foundation of America Medical Scientific Council, and has been on advisory boards for AstraZeneca, Genentech, and Novartis. Z. C. Chiesa Fuxench has served as a consultant for the National Eczema Association and the Asthma and Allergy Foundation, receiving honoraria, and receives or has received research grants (to the Trustees of the University of Pennsylvania) from Regeneron, Sanofi, Tioga and Vanda, and Menlo pharmaceuticals and Realm Therapeutics for work in atopic dermatitis; and has received payment for continuing medical education work related to atopic dermatitis that was supported indirectly by Regeneron and/or Sanofi. E. L. Simpson is an investigator for Eli Lilly Co., Galderma, Leo Pharmaceutical Co., Merck, Pfizer, Regeneron Pharmaceuticals, Inc., and a consultant with honorarium for AbbVie Inc., Boehringer Ingelheim, Dermavant, Eli Lilly Co., Incyte, Leo Pharmaceutical Co., Pfizer, Pierre Fabre Dermo Cosmetique, Regeneron Pharmaceuticals, Inc., and Sanofi Genzyme. P. Y. Ong is a coinvestigator of Atopic Dermatitis Research Network and has consulted for Pfizer and Theravance and has received research funding from Regeneron.JIS had full access to all the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis; and was involved in study concept and design, drafting of the manuscript, and statistical analysis. JIS, JMG, DJM, MB, LF, MHG, ZCCF, and PYO acquired, analyzed, and interpreted the data, and critically revised the manuscript for important intellectual content. Atopic Dermatitis in America is an independent research project of the Asthma and Allergy Foundation of America (AAFA) sponsored by Sanofi Genzyme and Regeneron.
Funding Information:
JIS had full access to all the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis; and was involved in study concept and design, drafting of the manuscript, and statistical analysis. JIS, JMG, DJM, MB, LF, MHG, ZCCF, and PYO acquired, analyzed, and interpreted the data, and critically revised the manuscript for important intellectual content. Atopic Dermatitis in America is an independent research project of the Asthma and Allergy Foundation of America (AAFA) sponsored by Sanofi Genzyme and Regeneron .
Publisher Copyright:
© 2019 American Academy of Allergy, Asthma & Immunology
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Background: Atopic dermatitis (AD) is associated with skin pain. However, little is known about the prevalence and associations of pain in AD. Objective: To characterize the frequency, intensity, characteristics, and associations of pain from AD. Methods: A cross-sectional, US population internet survey-based study of 602 adults with AD from the AD in America Study was performed (modified UK Working Party Criteria). Results: Overall, 365 (61%) reported pain from AD, with 199 (33%) experiencing pain at least once per week and 30 (5%) with pain daily. Among those with AD pain, 22% reported worst pain intensity ≥7. The frequency and intensity of AD pain were associated with Patient-Oriented Scoring Atopic Dermatitis (PO-SCORAD), PO-SCORAD itch and sleep, and Patient-Oriented Eczema Measure (P ≤ .004 for all). Among those experiencing AD pain, 179 (48%) reported pain occurring only after frequent scratching, 156 (42%) reported intermittent pain, and 27 (11%) reported constant pain throughout the day. AD pain was most commonly associated with open areas caused by scratching (27%) and fissures in the skin (27%), followed by inflamed red skin (25%), with only a minority reporting pain mostly caused by burning from creams or ointments (10%). Mild AD was associated with more pain from scratching, whereas severe AD was associated with more constant pain and pain from inflamed skin. Conclusions: Pain is a distinct symptom in AD, with heterogeneous frequency, characteristics, intensity, and quality of life impact. Pain was related to scratching, fissures, and/or inflamed red skin, and least from burning from topical medications. Skin pain should be assessed in patients with AD and monitoring treatment response.
AB - Background: Atopic dermatitis (AD) is associated with skin pain. However, little is known about the prevalence and associations of pain in AD. Objective: To characterize the frequency, intensity, characteristics, and associations of pain from AD. Methods: A cross-sectional, US population internet survey-based study of 602 adults with AD from the AD in America Study was performed (modified UK Working Party Criteria). Results: Overall, 365 (61%) reported pain from AD, with 199 (33%) experiencing pain at least once per week and 30 (5%) with pain daily. Among those with AD pain, 22% reported worst pain intensity ≥7. The frequency and intensity of AD pain were associated with Patient-Oriented Scoring Atopic Dermatitis (PO-SCORAD), PO-SCORAD itch and sleep, and Patient-Oriented Eczema Measure (P ≤ .004 for all). Among those experiencing AD pain, 179 (48%) reported pain occurring only after frequent scratching, 156 (42%) reported intermittent pain, and 27 (11%) reported constant pain throughout the day. AD pain was most commonly associated with open areas caused by scratching (27%) and fissures in the skin (27%), followed by inflamed red skin (25%), with only a minority reporting pain mostly caused by burning from creams or ointments (10%). Mild AD was associated with more pain from scratching, whereas severe AD was associated with more constant pain and pain from inflamed skin. Conclusions: Pain is a distinct symptom in AD, with heterogeneous frequency, characteristics, intensity, and quality of life impact. Pain was related to scratching, fissures, and/or inflamed red skin, and least from burning from topical medications. Skin pain should be assessed in patients with AD and monitoring treatment response.
KW - Atopic dermatitis
KW - Burden
KW - Eczema
KW - Epidemiology
KW - Itch
KW - Pain
KW - Severity
KW - Sign
KW - Symptom
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UR - http://www.scopus.com/inward/citedby.url?scp=85068438619&partnerID=8YFLogxK
U2 - 10.1016/j.jaip.2019.05.055
DO - 10.1016/j.jaip.2019.05.055
M3 - Article
C2 - 31228619
AN - SCOPUS:85068438619
SN - 2213-2198
VL - 7
SP - 2699-2706.e7
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
IS - 8
ER -