# Burden of Disease and Treatment Patterns in Adults with Atopic Dermatitis from the Baltic Region: Real-World Data from the ESSENTIAL AD Cross-Sectional Study

## TL;DR

This study examines the disease and economic burden of atopic dermatitis in Baltic adults, finding significant impacts on quality of life and treatment costs.

## Contribution

The study provides real-world data on AD management and outcomes in Baltic countries, where such data was previously lacking.

## Key findings

- AD patients in the Baltic region showed considerable disease burden with moderate severity scores and quality of life impacts.
- Patients on systemic therapy had higher hospitalization rates compared to those on non-systemic therapy.
- Out-of-pocket expenses varied significantly between Baltic countries, with Latvia having the highest costs.

## Abstract

Background and Objectives: Nationwide registries that provide comprehensive insights into the atopic dermatitis (AD) population and management in routine practice are lacking in Baltic countries. Real-world studies to explore the clinical and economic burden of AD are highly needed. We present findings from the Baltic cohort of the larger observational study ESSENTIAL AD, conducted in Europe, the Middle East, and Africa. Materials and Methods: This cross-sectional, retrospective chart review study enrolled adult AD patients routinely managed with systemic and/or non-systemic therapy in Estonia, Latvia, and Lithuania. Data was collected during one office visit. AD severity was assessed using the Eczema Area and Severity Index (EASI) and SCORing Atopic Dermatitis (SCORAD) and impact on quality of life was assessed using the Dermatology Life Quality Index (DLQI) (primary endpoints). Results: Fifty patients were enrolled, with a mean (standard deviation [SD]) age of 33.6 (11.67) years, and 60% were women. Mean (SD) time since AD diagnosis was 21.8 (14.8) years. An equal proportion of patients received systemic therapy (including combination therapy) or non-systemic therapy (50% each). Mean (SD) EASI, SCORAD, and DLQI total scores were 9.8 (9.76), 38.0 (16.5), and 10.5 (7.1), respectively. No significant difference was observed between patients receiving systemic and non-systemic therapy in terms of EASI (mean [SD] 11.5 [12.2] versus 8.2 [6.3]; p = 0.7636), SCORAD (35.4 [20.8] versus 40.6 [11.5]; p = 0.2563), and DLQI (9.5 [7.6] versus 11.5 [6.5]; p = 0.1962). Hospitalization rate (95% confidence interval) was significantly higher in patients on systemic versus non-systemic therapy (0.4 [0.2–0.8] versus 0.1 [0.0–0.4]; p = 0.0424). Monthly out-of-pocket expenses (USD) were higher in Latvia (mean [SD]: 103.7 [2.64]) versus Estonia (55.6 [1.82]) and Lithuania (53.8 [1.90]). Conclusions: Adult AD patients from the Baltic region still face a considerable disease and economic burden, regardless of treatment received. Improved disease management and better access to guideline-recommended advanced systemic therapies are necessary.