AD Patient Self-Confidence and Satisfaction Improved With Dupilumab Self-Injection

Patients with atopic dermatitis (AD) who were treated using subcutaneous self-injection experienced an increased in their overall satisfaction and self-confidence, according to a new study.¹ Self-injection has been available for patients in Japan since May 2019, just over a year after the drug dupilumab was approved refractory to topical therapies for adults with AD.

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The study, which was retrospective in nature and collected patient data, sought to explore patient perceptions before and after self-injection. Researchers noted that while, “Self-injection at home can release patients from regular clinic visits, leading to higher adherence. ...anxiety against self-injection, lack of confidence, and the complicated procedure could prevent initiation of self-injection.”

From March 2020 to June 2021, researchers collected patient data from adult patients with AD who presented to a single hospital center for self-injection treatment.

Prior to their first self-injection of dupilumab, participants (n=36) completed a pre-treatment Self-Injection Assessment Questionnaire (SIAQ). All patients were asked to answer questions about their self-confidence, self-image, overall feelings toward injections, and more.

Three months after completing their self-injection, patients were again asked to fill out the same SIAQ questionnaire. Meanwhile, researchers also collected data on the Eczema Area and Severity Index (EASI) and visual analog scale (VAS) of pruritus.

At baseline, the average patient EASI score was 30.8 ± 10.7, and the average VAS score of pruritus at baseline was 60.7 ± 21.7/100 mm. Three months after treatment, the average patient EASI score was 10.6 ± 5.4, while the average VAS score of pruritus was 24.8 ± 19.0/100 mm.

Regarding SIAQ scores, patients reported improvements in their overall feelings about injections, self-confidence, and satisfaction with self-injection. Researchers analyzed the associations between these scores and other underlying factors, finding that satisfaction with self-injection was both positively and strongly associated with ease of device use. Self-confidence and injection-site reaction demonstrated a similar correlation.

Researchers noted that a potential study limitation was the limited sample size of patients with AD.

“Self-confidence and satisfaction with self-injection improved 3 months after initiating self-injection of dupilumab in AD patients. Reduction of anxiety was observed in patients over 40 years old and patients who felt anxious about self-injection 3 months after initiating self-injection,” wrote Ito et al. “Satisfaction with self-injection was mainly influenced by ease of use of the device, self-confidence, and injection-site reaction. Before initiating self-injection, AD patients tend to be anxious, have low self-confidence, and be less satisfied with self-injection compared with PsA [psoriatic arthritis] patients. Our results could be helpful for patients who dither to introduce self-injection due to anxiety and/or lack of confidence.”

Reference

1. Ito M, Kamata M, Ishikawa T, et al. Improvements in self‐confidence and satisfaction with self‐injection after introducing self‐injection of dupilumab in patients with atopic dermatitis. J Cutan Immunol Allergy. Published online July 6, 2023. doi:10.1002/cia2.12313