Impact of atopic dermatitis treatment on child and parent sleep, daytime functioning, and quality of life

Meltzer, Lisa J.; Flewelling, Kassie D.; Jump, Stephanie; Gyorkos, Elizabeth A.; White, Michael P.; Hauk, Pia J.

doi:10.1016/j.anai.2019.12.024

Cited by 22 publications

(14 citation statements)

References 50 publications

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“…Subjective sleep disturbances are common among children with AD and their parents 17 . We observed 88.2% reduction for S‐NRS, while LIBERTY AD ADOL study reported 47.9% reduction 9 .…”

Section: Discussionmentioning

confidence: 55%

A 24‐weeks real‐world experience of dupilumab in adolescents with moderate‐to‐severe atopic dermatitis

Napolitano

Fabbrocini

Potestio

et al. 2022

Dermatologic Therapy

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Dupilumab is a monoclonal antibody approved for the treatment of moderate‐to‐severe atopic dermatitis (AD) in patients aged ≥12 years. Large, double‐blind, randomized, placebo‐controlled trials showed its efficacy and safety in adolescents. However, real‐life data are few. The aim of this monocentric retrospective observational study (December 2020–November 2021) was to assess the effectiveness and safety of dupilumab in AD adolescents treated for at least 24 weeks. For each patient demographic features, clinical data and adverse events (AEs) were collected. Eczema Area and Severity Index (EASI), Numerical Rating Scale (NRS) for pruritus (P‐NRS) and for sleep disturbances (S‐NRS), and Children Dermatology Life Quality Index (cDLQI) were assessed at baseline, week (W)4, W16, and W24. Twenty‐seven patients (18 males; 15.23 ± 3.54 years) were enrolled. Dupilumab was administered subcutaneously at dosage of 600 mg induction dose, followed by 300 mg every 2 weeks in 14 (51.85%) patients with a weight ≥60 kg, while 13 (48.15%) patients with a weight <60 kg were treated with dupilumab 200 mg every 2 weeks after a loading dose of 400 mg. The mean EASI score at baseline was 26.96 ± 4.93 and significantly reduced to 3.74 ± 3.47 at W16 (<0.001), and to 3.4 ± 5.04 at W24 (p < 0.001). P‐NRS (9.14 ± 0.94 at baseline vs. 2.33 ± 4.93 at W16 [p < 0.001], and 1.45 ± 2.35 at W24 [p < 0.001]), S‐NRS (7.88 ± 1.64 at baseline vs. 0.92 ± 1.35 at W16 [p < 0.001], and 1.66 ± 2.84 at W24 [p < 0.0001]) and cDLQI (26.62 ± 4.45 vs. 2.18 ± 3.51 at baseline vs. 2.18 ± 3.51 at W16 [p < 0.001], and 3.4 ± 5.02 at W24 [p < 0.001]) showed a statistically significative improvement as well. Injection‐site reaction (5/27; 18.52%), conjunctivitis (2/27; 7.41%), and asthenia (2/27; 7.41%) were the main AEs collected. This study seems to confirm the efficacy and safety of dupilumab in adolescents with moderate‐to‐severe AD also in real‐life setting.

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“…Subjective sleep disturbances are common among children with AD and their parents 17 . We observed 88.2% reduction for S‐NRS, while LIBERTY AD ADOL study reported 47.9% reduction 9 .…”

Section: Discussionmentioning

confidence: 55%

A 24‐weeks real‐world experience of dupilumab in adolescents with moderate‐to‐severe atopic dermatitis

Napolitano

Fabbrocini

Potestio

et al. 2022

Dermatologic Therapy

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“…According to the World Health Organization [ 16 ], HRQoL is the personal judgment of one’s health and diseases, including a multidimensional assessment of a person’s satisfaction with life and the perceptions of his or her position in life in different contexts. Previous studies of children’s sleep or HRQoL have mostly focused on different health problems and diagnoses such as epilepsy [ 17 ], asthma [ 18 ], atopic dermatitis [ 19 ] and type 1 diabetes [ 20 ]. No study is found of sleep and HRQoL in young healthy children.…”

Section: Introductionmentioning

confidence: 99%

Sleep and its relation to health-related quality of life in 3–10-year-old children

Sundell

Angelhoff

2021

BMC Public Health

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Background Considering the reports of increasing sleep problems in children, affecting health and well-being in young children and their families, we found it important to gain more knowledge about sleep and its correlation to health-related quality of life (HRQoL) in young, healthy children. The aims with this study were to describe sleep quality, sleep duration, and HRQoL in healthy 3–10-year-old children and to test associations between children’s sleep and HRQoL. Methods Parents of 160 children (average age: 6.9 years, SD ±2.2) participated in the study. Sleep onset problems (SOP), sleep maintenance problems (SMP), and sleep duration were measured by the Pediatric Insomnia Severity Index (PISI). KIDSCREEN-27 was used to measure HRQoL in five dimensions: physical well-being, psychological well-being, autonomy and parent relation, social support and peers, and school environment. Results The average score was 2.2 for SOP (SD +/− 2.2) and 1.3 for SMP (SD +/− 1.6). Few children (2%) were reported to sleep less than 8 h per night. Younger children had statistically significant higher SOP and SMP than older children. Correlations were found between SOP and poor psychological well-being (p < 0.05, ρ = − 0.16), and between SMP and poor physical wellbeing (p < 0.05, ρ = − 0.16), psychological well-being (p < 0.05, ρ = − 0.21), poor school environment (p < 0.01, ρ = − 0.29), autonomy and parent relation (p < 0.05, ρ = − 0.16), and poor social support and peers (p < 0.05, ρ = − 0.19). Conclusion Children’s sleep associates with health-related quality of life and needs to be acknowledged in child health care settings and schools.

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“…Infants with an early eczema onset, especially within 4 months after birth, are at an increased risk of developing food allergies at 3 years of age [ 45 ]. Moreover, AD is also known to decrease quality of life among family members and caregivers, deteriorating personal relationships, psychosocial functioning, sleep, and finances [ 46 - 48 ]; the parents’ ability to manage their children’s behavior and illness is influenced by the severity of AD [ 49 ]. Our findings show that interventions that facilitate parents’ active engagement can improve treatment outcomes and the holistic well-being of the family.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Pediatric Teleconsultation to Prevent Skin Conditions in Infants and Reduce Parenting Stress in Mothers: Randomized Controlled Trial

Ando¹,

Mori²,

Takehara³

et al. 2022

JMIR Pediatr Parent

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Background In Japan, eHealth for infants and mothers is currently an important aspect, but its effectiveness has rarely been examined. For infants, skin problems, including atopic dermatitis (AD), which is known to lead to other allergic diseases, are one of the most common conditions. Mothers of infants are prone to experiencing parenting stress, which adversely affects mothers’ and children’s well-being. Additionally, studies have reported that AD among offspring enhances parenting stress, and postnatal maternal psychological problems can increase the risk of AD in children. Objective This study evaluated the effectiveness of pediatric teleconsultation for preventing AD in infants and reducing parenting stress in mothers in Japan. Methods The study was an open-label, randomized, parallel-armed controlled trial. In total, 318 pairs of infants and mothers in the Yokohama City Sakae Ward were recruited when they submitted birth cards to the ward, received the explanation about the trial, and provided informed consent on the website for this trial. Eligible pairs of infants and mothers were randomly assigned to the intervention group (n=140) or the control group (n=138). Participants in the intervention and control groups received routine postnatal care from local government services. In addition, participants in the intervention group had the option to combine routine pediatric services with teleconsultation and email newsletters without charge from the date of registration until the infant turned 4 months. Primary outcomes were (1) the prevalence of AD in infants diagnosed based on the United Kingdom Working Party criteria and (2) parenting stress and mental status of mothers assessed using the Parenting Stress Index-Short Form (PSI-SF) and General Health Questionnaire-12 (GHQ-12). Data were collected by the ward office staff and researcher during the 4-month checkup. Results The prevalence of AD in infants was significantly lower in the intervention group than in the control group during the 4-month checkup (20% vs 33%, P=.03; relative risk ratio, 0.614 [95% CI 0.406-0.927]). No significant differences were observed in the PSI-SF and GHQ-12 scores between the 2 groups. There was a significant difference in the prevalence of AD between participants who used teleconsultation services and email newsletters, participants who did not use teleconsultation services but received email newsletters, and participants who neither received nor used either service (18% vs 22% vs 33%, P=.048). Conclusions This is the first randomized controlled trial demonstrating that routine pediatric care combined with teleconsultation and email newsletters was effective in reducing the prevalence of AD in infants. The findings highlight the potential of pediatric eHealth to become a useful new strategy for preventing AD. Trial Registration University Hospital Medical Information Network Clinical Trials Registry UMIN000029774; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000034022

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Impact of atopic dermatitis treatment on child and parent sleep, daytime functioning, and quality of life

Cited by 22 publications

References 50 publications

A 24‐weeks real‐world experience of dupilumab in adolescents with moderate‐to‐severe atopic dermatitis

A 24‐weeks real‐world experience of dupilumab in adolescents with moderate‐to‐severe atopic dermatitis

Sleep and its relation to health-related quality of life in 3–10-year-old children

Effectiveness of Pediatric Teleconsultation to Prevent Skin Conditions in Infants and Reduce Parenting Stress in Mothers: Randomized Controlled Trial

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