Patient treatment needs in atopic dermatitis: A real-world cohort study.
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Ludemann Kristina, Traidl Stephan, Cornelius Angela, Naim Joëlle, Heratizadeh Annice, Honstein Tatjana, Kind Barbara, Heinrich Luise, Harder Inken, Stölzl Dora, Augustin Matthias, Schaefer Thomas, Bong Anne, Abraham Susanne, Pinter Andreas, Ramaker-Brunke Jutta, Schulz-Kiesow Michael, Quist Sven, Schwarz Beate, Biedermann Tilo, Asefi Mohammad, Mann Caroline, Adler Nicole, Sticherling Michael, Schaekel Knut, Herrmann Anke, Meinhardt Kathrin, Stahl Maren, Handrick Christiane, Anders Sabine, Weidinger Stephan, Schmitt Jochen, Werfel Thomas, TREATgermany study group
Аннотация
OBJECTIVES: This study aimed to systematically assess and rank treatment needs in adults with moderate to severe AD, identify patient subgroups with distinct need profiles and evaluate how well these needs were met after 2 years of specialized dermatological care.
METHODS: In this prospective observational study from the TREATgermany registry, 697 adults with moderate to severe AD completed the validated Patient Benefit Index (PBI) at baseline (T1) and at 2-year follow-up (T2), capturing treatment goal importance and achievement. Subgroup analyses were performed based on age, sex, educational status and age at AD onset. Associations between clinical measures and perceived benefit were analysed.
RESULTS: The most frequently prioritized treatment goals were being free of itching (97.8% high agreement), regaining control of the disease (95.3%) and relief from skin burning (92.0%). The importance of itch reduction was not correlated with baseline pruritus intensity, and perceived benefit was more closely linked to relative clinical improvement than to absolute disease severity. Beyond these shared priorities, treatment needs varied across subgroups: older patients valued treatment safety and reduced dependence on medical care, women emphasized psychosocial and appearance-related goals, individuals with lower educational status highlighted financial concerns and patients with adult-onset AD prioritized diagnostic certainty and disease control. After 2 years, 96.6% of patients reported meaningful treatment benefit. Patient-reported outcomes (POEM) were more strongly associated with perceived benefit than physician-assessed measures (oSCORAD, EASI).
CONCLUSION: Patient treatment needs in AD vary by demographic and clinical factors, with pruritus consistently rated as the highest priority. Patient-reported outcomes align more closely with perceived benefit than physician assessments, underscoring the value of systematic needs assessments to guide individualized treatment decisions and shared decision-making.