Dupilumab Improves Work Quality of Life in Patients With AD

A new study found atopic dermatitis (AD) can have a significant impact on patients’ ability to work and on their work lives, although the data also showed that successful treatment can reverse those negative impacts.

The findings pertain specifically to treatment with dupilumab (Dupixent), a monoclonal immunoglobulin G4 (IgG4) antibody approved in 2017 to treat AD. The drug is also indicated for asthma and chronic rhinosinusitis with nasal polyposis.

Researchers sought to investigate work ability and quality of working life among patients experiencing AD.

The investigators said that AD is associated with increased use of sick leave, greater likelihood of job loss or job change, and receiving disability pensions. They also noted that an analysis of the German national database for AD, TREATgermany, “has shown that moderate-to-severe AD has a substantial adverse economic impact with a mean productivity loss of almost 10%.”

Authors decided to evaluate AD’s impact on work using 2 instruments, the World Ability Index (WAI) and the Quality of Working Life Questionnaire (QWLQ). They used the instruments to interview 93 patients when they began treatment with dupilumab (baseline) at 24 weeks, and at the 48-week mark. Findings were published in The Journal of Dermatology.

Baseline and 24-week assessments were completed by 72 patients, and 37 of those participants also completed 48-week assessments.

Scores for all 3 of the WAI questions used in the study improved over the course of the investigation after patients began dupilumab.

Scores on Question 1 of the WAI, which probed general work ability, increased from 6.8 (SD 2.0) on a scale of 0-10 to 7.9 (1.3) from baseline to 48 weeks. Scores for Question 2, judging physical work ability, rose from 3.7 (0.9) to 4.3 (0.7) on a scale of 1 to 5. Scores on mental/emotional work ability (WAI-3) went from 3.4 (0.9) to 3.9 (0.8) on a scale of 1 to 5.

On the QWLQ assessment, mean total score improved from 74.0 (9.1) to 77.5 (9.6) on a scale of 0 to 100, while on the subscale “problems due to health situation,” the scores jumped from 37.4 (22.3) to 61.5 (23.1).

“Patients report a decreased work ability and experience a high burden regarding QWL, in particular due to health-related problems,” researchers said. “There seems to be significant improvement of work ability and QWL with dupilumab treatment over time.”

As for the causes of work-related difficulties, authors found most patients reported combinations of issues, including pruritus, fatigue, pain, and psychological complaints. The investigators said broader studies might be able to better pick up on trends and could gauge the value of targeted interventions in improving quality of life and quality of work life in this patient group, such as providing supportive care.

“A need exists for development of programs that can support this demand,” they concluded. “Furthermore, investigating the impact on work productivity specifically can contribute to determining the cost-effectiveness of treatments.”

Reference:

Bosma AL, Ouwerkerk W, Günal M, et al. Work ability and quality of working life in atopic dermatitis patients treated with dupilumab. J Dermatol. Published online May 19, 2021. doi:10.1111/1346-8138.15939