Treatment satisfaction and quality of life in Korean moderate to severe atopic dermatitis patients based on current targeted therapy

초록

Atopic dermatitis (AD) impairs quality of life (QoL). In Korea, under national health insurance, only severe AD qualifies for reimbursed targeted therapy, limiting access for moderate AD despite negative impact on QoL. This study evaluated the clinical features, QoL, and treatment satisfaction in patients with moderate and severe AD, comparing targeted with non-targeted therapy. Between Oct 2023–Apr 2024, AD patients aged ≥12 were enrolled and grouped by EASI score (moderate <23; severe ≥23). Patients continuing the same therapy for 12–24 weeks were enrolled. The groups were divided by targeted (JAK inhibitor and dupilumab) and non-targeted (conventional systemic) therapy. Satisfaction, QoL, and clinical features were measured by DLQI/CDLQI, TSQM, and medical records. The moderate and severe AD patients included 84 [mean ± SD age 27.3 ± 9.9 years, EASI 17.1 ± 1.5] and 87 [25.7 ± 7.7 years, 26.1 ± 3.9]. In moderate AD, patients with lichenification (targeted vs non-targeted; 82.1% vs 30.4%, p < 0.01) and erythema (39.3% vs 16.1%, p = 0.04) received targeted therapy more often than non-targeted therapy. DLQI/CDLQI were not significantly different between targeted and non-targeted therapy in both groups. In moderate AD, non-targeted therapy yielded higher TSQM for side effects (p = 0.03). Patients treated with targeted therapy in severe AD reported significantly higher effectiveness and global satisfaction on the TSQM (p < 0.01). Targeted therapy in severe AD improved satisfaction on effectiveness and overall experience of treatment. Patients with lichenification and erythema in moderate AD could be considered for targeted therapy. The marginal difference in QoL between the groups suggests that various aspects (e.g., demographic, clinical features, and reimbursement, etc.) should be considered when evaluating QoL, which is not fully explained by (C)DLQI alone.