Atopic Dermatitis: Disease Burden in Young Children: Results from the PEDISTAD Global Registry

Atopic dermatitis is a chronic relapsing inflammatory condition that imposes a considerable burden on children and their families. We aimed to investigate the disease burden and quality-of-life impact across three age groups of children with moderate-to-severe atopic dermatitis. PEDISTAD is an observational global registry of children aged < 12 years with moderate-to-severe atopic dermatitis. Physician-reported disease characteristics, atopic comorbidities, treatment patterns, and patient/caregiver-reported quality-of-life measures are being collected over a period of 10 years. Patients were enrolled in the PEDISTAD Global Registry between September 2018 and April 2024; the data reported here are from a database lock on 31 July 2024. A total of 1612 patients enrolled in PEDISTAD were included in this analysis, of which 238 were aged < 2 years, 645 aged 2 to < 6 years, and 729 aged 6 to < 12 years. The age of onset of atopic dermatitis was early in life. The incidence of asthma, allergic rhinitis, and allergic conjunctivitis increased with age. Mean Eczema Area and Severity Index scores were 14.1, 13.4, and 14.7 for patients aged < 2 years, 2 to < 6 years, and 6 to < 12 years, respectively. With regard to the itch burden and resultant scratching reported by parents and caregivers of the youngest children, the numerical rating score was 5.5 and 5.8 in both 0 to < 2 years and 2 to < 6 years, respectively. For those aged 6 to < 12 years, the itch burden was highest at night, with a Numeric Rating Scale score of 4.9 versus 3.8 during the day. Patient/caregiver-reported measures of disease burden were high for all age groups. The quality of life of the entire family was affected in multiple ways, as measured by the mean Dermatitis Family Impact score, which was higher in children aged < 2 years (12.0) and 2 to < 6 years (11.9), compared with patients aged 6 to < 12 years (10.2). A high/lot of impact was reported on the sleep of the family unit (in children aged < 2 years [45.9%] and 2 to < 6 years [51.9%], compared with patients aged 6 to < 12 years (33.8%). There was a high burden of tiredness and exhaustion among caregivers, particularly in the youngest two age groups but still showing a substantial impact on the families of those aged 6 to < 12 years. Children with moderate-to-severe atopic dermatitis have a high disease burden, with severe itch and poor sleep impacting their own health and quality of life and that of their entire family. ClinicalTrials.gov Identifier: NCT03687359. Atopic dermatitis, also called eczema, is a chronic systemic disease that causes dry skin, skin inflammation, and itching that leads to scratching and further skin damage. Atopic dermatitis occurs frequently in young children and often develops during the first year of life. Children with atopic dermatitis are also at risk of developing other allergic diseases, including asthma, food allergy, hay fever, and allergic eye redness. Our study looked at the disease burden in 1612 children aged under 12 years diagnosed with moderate-to-severe atopic dermatitis. The disease burden of children was high, with severe itch and poor sleep. The quality of life of the entire family was affected in multiple ways, including sleep, relationships, leisure activities, and the ability to complete normal household tasks. The impact on the family was higher in younger children (aged under 6 years), but atopic dermatitis also had a large effect on the family of children aged 6–11 years. Tiredness and exhaustion were reported as an issue, again being slightly more of a problem for families with younger children. Increased costs as a result of treatment were also reported, adding to the burden suffered by the family unit.