Atopic dermatitis: economic burden and strategies for high‐quality care

Ismail, Normala; Bray, Nathan

doi:10.1111/bjd.18636

Cited by 8 publications

(7 citation statements)

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“…In addition, work productivity and activities of adult patients are impaired by the presence of AD [ 6 , 7 ]. Furthermore, considerable economic costs also represent a burden to the affected individual and society [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Association of Atopic Dermatitis with Depression and Suicide: A Two-Sample Mendelian Randomization Study

2022

BioMed Research International

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Background. Atopic dermatitis (AD) has long been hypothesized to be associated with risk of depression and suicide, but the causal relationship between them is still unclear. Objective. To evaluate the causality between AD, depression, and suicide using a Mendelian randomization (MR) approach. Method. We extracted summary-level data for AD, major depression, and suicidal ideation or attempt from published, nonoverlapping genome-wide association studies (GWAS). Inverse variance-weighted (IVW) analysis was used as the primary analysis. Alternate methods, including weighted median, MR Egger, MR pleiotropy residual sum and outlier, weighted mode, and leave-out analysis, were performed to assess pleiotropy. Results. 13 SNPs (13,287 cases and 41,345 controls) were selected as instrumental variables (IVs). The IVW analysis indicated a statistically significant but small causal effect of AD on major depression ( OR = 1.027 , 95% CI 1.004-1.050; p = 0.020 ). No significant evidence was observed for a causal effect of AD on suicide. No significant effect of pleiotropy was found. Conclusion. AD has a significant but small effect on major depression, but not on suicide.

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Section: Introductionmentioning

confidence: 99%

Association of Atopic Dermatitis with Depression and Suicide: A Two-Sample Mendelian Randomization Study

2022

BioMed Research International

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“…[3][4][5][6] The pathogenesis is complex, involving genetic susceptibility, impaired skin barrier function, dysfunctional cell-mediated immunity, and environmental and lifestyle factors. 7,8 AD is also associated with sleep disruption (mainly due to pruritus), decreased work productivity, 9 and depression and anxiety, which all carry additional health and economic burdens for patients and their families. 10 Assessing the economic burden of AD is complex as it consists of costs for medical care and nonmedical care and indirect costs (e.g.…”

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confidence: 99%

The global burden of atopic dermatitis: lessons from the Global Burden of Disease Study 1990–2017*

et al. 2020

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Summary Background The Global Burden of Disease (GBD) Study provides an annually updated resource to study disease‐related morbidity and mortality worldwide. Objectives Here we present the burden estimates for atopic dermatitis (AD), including data from inception of the GBD project in 1990 until 2017. Methods Data on the burden of AD were obtained from the GBD Study. Results Atopic dermatitis (AD) ranks 15th among all nonfatal diseases and has the highest disease burden among skin diseases as measured by disability‐adjusted life‐years (DALYs). Overall, the global DALY rate for AD in 1990 was 121 [95% uncertainty interval (UI) 65·4–201] and remained similar in 2017 at 123 (95% UI 66·8–205). The three countries with the highest DALY rates of AD were Sweden (327, 95% UI 178–547), the UK (284, 95% UI 155–478) and Iceland (277, 95% UI 149–465), whereas Uzbekistan (85·1, 95% UI 45·2–144), Armenia (85·1, 95% UI 45·8–143) and Tajikistan (85·1, 95% UI 46·1–143) ranked lowest. Conclusions The global prevalence rate of AD has remained stable from 1990 to 2017. However, the distribution of AD by age groups shows a bimodal curve with the highest peak in early childhood, decreasing in prevalence among young adults, and a second peak in middle‐aged and older populations. We also found a moderate positive correlation between a country’s gross domestic product and disease burden. GBD data confirm the substantial worldwide burden of AD, which has remained stable since 1990 but shows significant geographical variation. Lifestyle factors, partially linked to affluence, are likely important disease drivers. However, the GBD methodology needs to be developed further to incorporate environmental risk factors, such as ultraviolet exposure, to understand better the geographical and age‐related variations in disease burden.

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“…AD had the highest disability adjusted life year (DALY) burden of all skin diseases and ranked the 15th among all nonfatal diseases globally 3 . In addition, AD is commonly associated with sleep disturbances, negative emotions, and decreased productivity, which seriously affects the patients' quality of life 4 . AD has become one of the most intractable public health issues worldwide.…”

Section: Introductionmentioning

confidence: 99%

“… 3 In addition, AD is commonly associated with sleep disturbances, negative emotions, and decreased productivity, which seriously affects the patients' quality of life. 4 AD has become one of the most intractable public health issues worldwide.…”

Section: Introductionmentioning

confidence: 99%

The efficacy and safety of oral microecological agents as add‐on therapy for atopic dermatitis: A systematic review and meta‐analysis of randomized clinical trials

Xue,

Qin,

Qin

et al. 2023

Clinical & Translational All

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BackgroundAtopic dermatitis (AD) is a common skin disease that is hard to completely cure in a short time. Guidelines recommend the use of topical corticosteroids (TCS) as first‐line anti‐inflammatory therapy for AD, but long‐term use has significant side effects. Microecological agents (MA), including probiotics, prebiotics and synbiotics, have been widely reported as a potential adjunctive therapy of AD, but whether MA can contribute to AD treatment is currently controversial. Therefore, we conducted a systematic review and meta‐analysis to investigate whether MA as an add‐on therapy for AD has synergistic and attenuated effects and to further understand the role of MA in clinical interventions for AD.MethodsWe systematically searched Medline, Embase, Web of Science, Cochrane Library and PsycINFO databases up to Apr 11, 2023, and bibliographies were also manually searched, for potentially relevant studies regarding MA as additional therapy of AD. The Cochrane Risk of Bias Tool for assessing risk of bias was used to assess the quality of randomized controlled trials (RCTs). Two reviewers screened studies, extracted data, and evaluated the risk of bias independently. The primary outcomes (SCORAD scores and the number of adverse events) and the secondary outcomes (pruritus scores, the quality of life and the frequency of TCS) were extracted from each article. The data were combined and analyzed to quantify the safety and efficacy of the treatment. R (V4.4.3) software was used for data synthesis. The certainty of the evidence was evaluated with the Grade of Recommendation, Assessment, Development and Evaluation (GRADE) system. We also performed a trial sequential analysis to assess the reliability of the evidence.ResultsA total of 21 studies, including 1230 individuals, were identified, 20 of which met the eligibility criteria for the meta‐analysis. Our pooled meta‐analyses showed that compared with controls, oral MA as an add‐on therapy was associated with significantly lower SCORAD scores (MD = −5.30, 95% CI −8.50, −1.55, p < 0.01, I2 = 81%). However, adverse events, pruritus scores, quality of life, and frequency of TCS use showed no significant difference in this meta‐analysis study (p > 0.05).ConclusionsThis meta‐analysis showed that MA plus TCS could be an effective and safe treatment for patients with AD to relieve relevant symptoms, which might be used as an add‐on therapy in the treatment of AD. However, due to the limited number of studies, results should be interpreted with caution. Further studies with a larger sample size are needed to explore the optimal protocol of MA plus TCS.

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Atopic dermatitis: economic burden and strategies for high‐quality care

Abstract: Linked Article: Olsson et al. Br J Dermatol 2020; 182:1245–1252.

Cited by 8 publications

References 8 publications

Association of Atopic Dermatitis with Depression and Suicide: A Two-Sample Mendelian Randomization Study

Association of Atopic Dermatitis with Depression and Suicide: A Two-Sample Mendelian Randomization Study

The global burden of atopic dermatitis: lessons from the Global Burden of Disease Study 1990–2017*

The efficacy and safety of oral microecological agents as add‐on therapy for atopic dermatitis: A systematic review and meta‐analysis of randomized clinical trials

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