Prevalence and associations of fatigue in childhood atopic dermatitis: A cross-sectional study

Stephanie M. Rangel; Theodore Kim; Anjani Sheth; Alli Blumstein; Jin Shei Lai; David Cella; Amy S. Paller; Jonathan I Silverberg

doi:10.1111/jdv.18819

Prevalence and associations of fatigue in childhood atopic dermatitis: A cross-sectional study

Stephanie M. Rangel, Theodore Kim, Anjani Sheth, Alli Blumstein, Jin Shei Lai, David Cella, Amy S. Paller^*, Jonathan I Silverberg^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Background: Fatigue is a symptom that can negatively impact patients' quality of life. However, the relationship of AD with fatigue has not been fully studied, especially in children. Objective: To determine the prevalence of fatigue in AD patients, and whether AD severity, demographics and comorbidities are associated with increased fatigue in children. Methods: A cross-sectional observational study was performed among 248 children with AD. Paediatric patients (ages 8–17 years) and parents (of children ages 0–17 years) completed a questionnaire, including demographics, history of atopic comorbidities and validated severity measures of AD, itch, pain, sleep disturbance, sleep-related impairment and fatigue. AD severity was also assessed by clinician-reported Eczema Area and Severity Index (EASI), Scoring AD (SCORAD) and Investigator's Global Assessment (IGA). Fatigue was assessed using Patient Reported Outcome Measurement Information System (PROMIS) Pediatric Fatigue T-score. Results: Most children with AD had no (38.6%) or mild (32.1%) fatigue, with fewer having moderate (27.2%) or severe (2%) fatigue. Moderate/severe PROMIS Pediatric fatigue T-scores were increased with moderate (25.7%/1.4%) and severe (39.3%/5.4%) IGA vs. mild IGA (18.0%/0.0%) and those with 5–6 (44.4%/0.0%) and 7 (44.2%/5.2%) nights of SD from eczema. Moderate–severe PROMIS Pediatric Fatigue T-scores were associated with history of hay fever (adjusted OR [95% Cl]: 2.803 [1.395–5.632]) and family income (<$100,000: 3.049 [1.294–7.181]), but inversely with Black (0.40 [0.168–0.969]) and AAPI (0.285 [0.094–0.859]) race. In multivariable regression models controlling for demographic factors, PROMIS Pediatric Fatigue T-score was significant with more severe scores for IGA, POEM, EASI, SCORAD, NRS-itch, SCORAD-itch, average itch in the past 7 days, PROMIS Pediatric Pain severity, PROMIS Pediatric SD, PROMIS Pediatric SRI, SCORAD-sleep and more frequent SD from AD. Conclusions: Fatigue is a common yet underappreciated symptom in children with AD, particularly those with moderate–severe AD, and warrants more attention in clinical practice and trials.

Original language	English (US)
Pages (from-to)	763-771
Number of pages	9
Journal	Journal of the European Academy of Dermatology and Venereology
Volume	37
Issue number	4
DOIs	https://doi.org/10.1111/jdv.18819
State	Published - Apr 2023

Funding

SM Rangel, AS Paller and JI Silverberg had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. Study concept and design: AS Paller, SM Rangel, J-S Lai, D Cella. Acquisition of Data: AS Paller, SM Rangel. Analysis and interpretation of data: A Paller, T Kim, SM Rangel, JI Silverberg, A Sheth, A Blumstein. Drafting of the manuscript: T Kim, JI Silverberg. Critical revision of the manuscript for important intellectual content: JI Silverberg, AS Paller, SM Rangel, A Sheth, A Blumstein, J-S Lai, D Cella. Statistical analysis: T Kim, JI Silverberg. Administrative technical or material support: None. Study supervision: None.

ASJC Scopus subject areas

Dermatology
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/jdv.18819

Cite this

@article{317f084c34d8498e8f103ee4f376cce6,

title = "Prevalence and associations of fatigue in childhood atopic dermatitis: A cross-sectional study",

abstract = "Background: Fatigue is a symptom that can negatively impact patients' quality of life. However, the relationship of AD with fatigue has not been fully studied, especially in children. Objective: To determine the prevalence of fatigue in AD patients, and whether AD severity, demographics and comorbidities are associated with increased fatigue in children. Methods: A cross-sectional observational study was performed among 248 children with AD. Paediatric patients (ages 8–17 years) and parents (of children ages 0–17 years) completed a questionnaire, including demographics, history of atopic comorbidities and validated severity measures of AD, itch, pain, sleep disturbance, sleep-related impairment and fatigue. AD severity was also assessed by clinician-reported Eczema Area and Severity Index (EASI), Scoring AD (SCORAD) and Investigator's Global Assessment (IGA). Fatigue was assessed using Patient Reported Outcome Measurement Information System (PROMIS) Pediatric Fatigue T-score. Results: Most children with AD had no (38.6%) or mild (32.1%) fatigue, with fewer having moderate (27.2%) or severe (2%) fatigue. Moderate/severe PROMIS Pediatric fatigue T-scores were increased with moderate (25.7%/1.4%) and severe (39.3%/5.4%) IGA vs. mild IGA (18.0%/0.0%) and those with 5–6 (44.4%/0.0%) and 7 (44.2%/5.2%) nights of SD from eczema. Moderate–severe PROMIS Pediatric Fatigue T-scores were associated with history of hay fever (adjusted OR [95% Cl]: 2.803 [1.395–5.632]) and family income (<$100,000: 3.049 [1.294–7.181]), but inversely with Black (0.40 [0.168–0.969]) and AAPI (0.285 [0.094–0.859]) race. In multivariable regression models controlling for demographic factors, PROMIS Pediatric Fatigue T-score was significant with more severe scores for IGA, POEM, EASI, SCORAD, NRS-itch, SCORAD-itch, average itch in the past 7 days, PROMIS Pediatric Pain severity, PROMIS Pediatric SD, PROMIS Pediatric SRI, SCORAD-sleep and more frequent SD from AD. Conclusions: Fatigue is a common yet underappreciated symptom in children with AD, particularly those with moderate–severe AD, and warrants more attention in clinical practice and trials.",

author = "Rangel, {Stephanie M.} and Theodore Kim and Anjani Sheth and Alli Blumstein and Lai, {Jin Shei} and David Cella and Paller, {Amy S.} and Silverberg, {Jonathan I}",

note = "Funding Information: SM Rangel, AS Paller and JI Silverberg had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. Study concept and design: AS Paller, SM Rangel, J-S Lai, D Cella. Acquisition of Data: AS Paller, SM Rangel. Analysis and interpretation of data: A Paller, T Kim, SM Rangel, JI Silverberg, A Sheth, A Blumstein. Drafting of the manuscript: T Kim, JI Silverberg. Critical revision of the manuscript for important intellectual content: JI Silverberg, AS Paller, SM Rangel, A Sheth, A Blumstein, J-S Lai, D Cella. Statistical analysis: T Kim, JI Silverberg. Administrative technical or material support: None. Study supervision: None. Publisher Copyright: {\textcopyright} 2022 European Academy of Dermatology and Venereology.",

year = "2023",

month = apr,

doi = "10.1111/jdv.18819",

language = "English (US)",

volume = "37",

pages = "763--771",

journal = "Journal of the European Academy of Dermatology and Venereology",

issn = "0926-9959",

publisher = "John Wiley and Sons Inc.",

number = "4",

}

TY - JOUR

T1 - Prevalence and associations of fatigue in childhood atopic dermatitis

T2 - A cross-sectional study

AU - Rangel, Stephanie M.

AU - Kim, Theodore

AU - Sheth, Anjani

AU - Blumstein, Alli

AU - Lai, Jin Shei

AU - Cella, David

AU - Paller, Amy S.

AU - Silverberg, Jonathan I

N1 - Funding Information: SM Rangel, AS Paller and JI Silverberg had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. Study concept and design: AS Paller, SM Rangel, J-S Lai, D Cella. Acquisition of Data: AS Paller, SM Rangel. Analysis and interpretation of data: A Paller, T Kim, SM Rangel, JI Silverberg, A Sheth, A Blumstein. Drafting of the manuscript: T Kim, JI Silverberg. Critical revision of the manuscript for important intellectual content: JI Silverberg, AS Paller, SM Rangel, A Sheth, A Blumstein, J-S Lai, D Cella. Statistical analysis: T Kim, JI Silverberg. Administrative technical or material support: None. Study supervision: None. Publisher Copyright: © 2022 European Academy of Dermatology and Venereology.

PY - 2023/4

Y1 - 2023/4

N2 - Background: Fatigue is a symptom that can negatively impact patients' quality of life. However, the relationship of AD with fatigue has not been fully studied, especially in children. Objective: To determine the prevalence of fatigue in AD patients, and whether AD severity, demographics and comorbidities are associated with increased fatigue in children. Methods: A cross-sectional observational study was performed among 248 children with AD. Paediatric patients (ages 8–17 years) and parents (of children ages 0–17 years) completed a questionnaire, including demographics, history of atopic comorbidities and validated severity measures of AD, itch, pain, sleep disturbance, sleep-related impairment and fatigue. AD severity was also assessed by clinician-reported Eczema Area and Severity Index (EASI), Scoring AD (SCORAD) and Investigator's Global Assessment (IGA). Fatigue was assessed using Patient Reported Outcome Measurement Information System (PROMIS) Pediatric Fatigue T-score. Results: Most children with AD had no (38.6%) or mild (32.1%) fatigue, with fewer having moderate (27.2%) or severe (2%) fatigue. Moderate/severe PROMIS Pediatric fatigue T-scores were increased with moderate (25.7%/1.4%) and severe (39.3%/5.4%) IGA vs. mild IGA (18.0%/0.0%) and those with 5–6 (44.4%/0.0%) and 7 (44.2%/5.2%) nights of SD from eczema. Moderate–severe PROMIS Pediatric Fatigue T-scores were associated with history of hay fever (adjusted OR [95% Cl]: 2.803 [1.395–5.632]) and family income (<$100,000: 3.049 [1.294–7.181]), but inversely with Black (0.40 [0.168–0.969]) and AAPI (0.285 [0.094–0.859]) race. In multivariable regression models controlling for demographic factors, PROMIS Pediatric Fatigue T-score was significant with more severe scores for IGA, POEM, EASI, SCORAD, NRS-itch, SCORAD-itch, average itch in the past 7 days, PROMIS Pediatric Pain severity, PROMIS Pediatric SD, PROMIS Pediatric SRI, SCORAD-sleep and more frequent SD from AD. Conclusions: Fatigue is a common yet underappreciated symptom in children with AD, particularly those with moderate–severe AD, and warrants more attention in clinical practice and trials.

AB - Background: Fatigue is a symptom that can negatively impact patients' quality of life. However, the relationship of AD with fatigue has not been fully studied, especially in children. Objective: To determine the prevalence of fatigue in AD patients, and whether AD severity, demographics and comorbidities are associated with increased fatigue in children. Methods: A cross-sectional observational study was performed among 248 children with AD. Paediatric patients (ages 8–17 years) and parents (of children ages 0–17 years) completed a questionnaire, including demographics, history of atopic comorbidities and validated severity measures of AD, itch, pain, sleep disturbance, sleep-related impairment and fatigue. AD severity was also assessed by clinician-reported Eczema Area and Severity Index (EASI), Scoring AD (SCORAD) and Investigator's Global Assessment (IGA). Fatigue was assessed using Patient Reported Outcome Measurement Information System (PROMIS) Pediatric Fatigue T-score. Results: Most children with AD had no (38.6%) or mild (32.1%) fatigue, with fewer having moderate (27.2%) or severe (2%) fatigue. Moderate/severe PROMIS Pediatric fatigue T-scores were increased with moderate (25.7%/1.4%) and severe (39.3%/5.4%) IGA vs. mild IGA (18.0%/0.0%) and those with 5–6 (44.4%/0.0%) and 7 (44.2%/5.2%) nights of SD from eczema. Moderate–severe PROMIS Pediatric Fatigue T-scores were associated with history of hay fever (adjusted OR [95% Cl]: 2.803 [1.395–5.632]) and family income (<$100,000: 3.049 [1.294–7.181]), but inversely with Black (0.40 [0.168–0.969]) and AAPI (0.285 [0.094–0.859]) race. In multivariable regression models controlling for demographic factors, PROMIS Pediatric Fatigue T-score was significant with more severe scores for IGA, POEM, EASI, SCORAD, NRS-itch, SCORAD-itch, average itch in the past 7 days, PROMIS Pediatric Pain severity, PROMIS Pediatric SD, PROMIS Pediatric SRI, SCORAD-sleep and more frequent SD from AD. Conclusions: Fatigue is a common yet underappreciated symptom in children with AD, particularly those with moderate–severe AD, and warrants more attention in clinical practice and trials.

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Prevalence and associations of fatigue in childhood atopic dermatitis: A cross-sectional study

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UN SDGs

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