Supplementary Material for: Assessing disease control in patients with atopic dermatitis by using the Atopic Dermatitis Control Tool (ADCT) in daily practice

Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin disease, placing a significant burden on patients’ quality of life (QoL). The validated Atopic Dermatitis Control Tool (ADCT) is recommended to assess AD control in adults. The aim of this study is to assess AD control and explore associations with demographic characteristics, patient-reported outcome measures (PROMs), and treatment.
Methods: In this cross-sectional study, questionnaires were sent to 2066 adults from two tertiary referral centers who had previously physician-diagnosed AD and had visited the outpatient clinic at least once between 2020-2022. Questionnaires were completed between May and October 2022. AD control was assessed by the ADCT, with a score ≥7 indicating uncontrolled AD. AD severity, QoL and weekly average pruritus were simultaneously measured using the Patient-Oriented Eczema Measure (POEM), Dermatology Life Quality Index (DLQI), and Numeric Rating Scale (NRS), respectively, with higher scores indicating more severe symptoms. Moreover, treatment-related questions were included. Associations between uncontrolled AD, age, sex and treatment were explored using multivariate logistic regression analysis.
Results: In total, 863 patients (41.8%) filled out the questionnaire and 812 were included in the analysis, of which 59% reported controlled AD. Uncontrolled AD was associated with higher PROMs scores and receiving topical anti-inflammatories only (adjusted odds ratio (95% confidence interval) ranged from 1.33 (0.995-1.88) to 2.55 (2.21-2.86)). Of those treated with topical anti-inflammatories only, 54% reported uncontrolled AD.
Conclusion: The majority of the patients reported controlled AD. Patients with uncontrolled AD often reported more severe symptoms and were more likely to receive topical anti-inflammatories only. It could be considered to shift patients with uncontrolled AD from topical to systemic treatment.

引言：特应性皮炎（Atopic Dermatitis, AD）是一种慢性炎症性皮肤病，对患者的生活质量（QoL）造成显著负担。经验证的特应性皮炎控制工具（Atopic Dermatitis Control Tool, ADCT）被推荐用于成人AD病情控制情况的评估。本研究旨在评估AD的病情控制情况，并探索其与人口统计学特征、患者报告结局指标（Patient-Reported Outcome Measures, PROMs）以及治疗方案之间的关联。
方法：本项横断面研究中，研究人员向来自两家三级转诊中心的2066名成年患者发放了问卷，这些患者均经医师确诊为AD，且在2020年至2022年间至少有1次门诊就诊记录。问卷回收时段为2022年5月至10月。采用ADCT评估AD病情控制情况，得分≥7分提示AD未获控制。同时分别采用湿疹患者自评量表（Patient-Oriented Eczema Measure, POEM）、皮肤病生活质量指数（Dermatology Life Quality Index, DLQI）以及数字评分量表（Numeric Rating Scale, NRS）评估AD严重程度、生活质量以及每周平均瘙痒程度，得分越高提示症状越严重。此外，问卷中还包含了与治疗相关的问题。采用多因素logistic回归分析探索未控制AD与年龄、性别及治疗方案之间的关联。
结果：最终共有863名患者（占比41.8%）完成问卷，其中812名患者被纳入分析，59%的患者报告其AD病情已获控制。未控制AD与更高的PROMs评分以及仅接受局部抗炎治疗相关（校正后比值比（95%置信区间）范围为1.33（0.995~1.88）至2.55（2.21~2.86））。在仅接受局部抗炎治疗的患者中，54%报告其AD病情未获控制。
结论：多数患者报告其AD病情已获控制。未获控制的AD患者往往症状更为严重，且更倾向于仅接受局部抗炎治疗。临床可考虑将未控制AD患者的治疗方案从局部治疗调整为系统治疗。