Journal of the European Academy of Dermatology and VenereologyEarly View LETTER TO THE EDITOR Treatment of moderate-to-severe atopic dermatitis with baricitinib: Results from an interim analysis of the TREATgermany registry Stephan Traidl, Corresponding Author Stephan Traidl [email protected] orcid.org/0000-0003-4806-599X Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany Correspondence Stephan Traidl, Department of Dermatology and Allergy, Hannover Medical School (MHH), Carl-Neuberg-Str.1, 30625 Hannover, Germany. Email: [email protected]Search for more papers by this authorLuise Heinrich, Luise Heinrich Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, GermanySearch for more papers by this authorDoreen Siegels, Doreen Siegels orcid.org/0000-0002-4049-9120 Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, GermanySearch for more papers by this authorAnnice Heratizadeh, Annice Heratizadeh orcid.org/0000-0002-9231-9865 Department of Dermatology and Allergy, Hannover Medical School, Hannover, GermanySearch for more papers by this authorBarbara Kind, Barbara Kind Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, GermanySearch for more papers by this authorEva Haufe, Eva Haufe Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, GermanySearch for more papers by this authorSusanne Abraham, Susanne Abraham orcid.org/0000-0001-7457-6481 Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, GermanySearch for more papers by this authorThomas Schäfer, Thomas Schäfer Practice Dr. Med. Thomas Schaefer/Dr. Med. Doreen Belz, Derma Koeln, Köln, GermanySearch for more papers by this authorMatthias Augustin, Matthias Augustin orcid.org/0000-0002-4026-8728 Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf, Hamburg, GermanySearch for more papers by this authorInken Harder, Inken Harder Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, GermanySearch for more papers by this authorAndreas Pinter, Andreas Pinter orcid.org/0000-0002-1330-1502 Department of Dermatology, Venereology and Allergology, Clinical Research, University Hospital Frankfurt am Main, Frankfurt am Main, GermanySearch for more papers by this authorKnut Schäkel, Knut Schäkel orcid.org/0000-0001-6344-7799 Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, GermanySearch for more papers by this authorAndreas Wollenberg, Andreas Wollenberg orcid.org/0000-0003-0177-8722 Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany Department of Dermatology and Allergy, University Hospital Augsburg, Augsburg, Germany Comprehensive Center for Inflammation Medicine, University of Luebeck, Luebeck, GermanySearch for more papers by this authorKonstantin Ertner, Konstantin Ertner Practice Dr. Med. Konstantin Ertner, Nuernberg, GermanySearch for more papers by this authorJutta Ramaker-Brunke, Jutta Ramaker-Brunke Practice 'Die Hautärzte' Braunschweig, Braunschweig, GermanySearch for more papers by this authorAnne Bong, Anne Bong Practice Dr. Med. Anne Bong, Emmerich, GermanySearch for more papers by this authorSven Quist, Sven Quist Dermatology Clinic, Helix Medical Excellence Center Mainz, Mainz, GermanySearch for more papers by this authorHannah Gorriahn-Maiterth, Hannah Gorriahn-Maiterth Practice Dermasana Karlsruhe, Karlsruhe, GermanySearch for more papers by this authorFlorian Schenck, Florian Schenck Dermatology Center Hannover, Hannover, GermanySearch for more papers by this authorMichael Sticherling, Michael Sticherling Department of Dermatology, University, German Center for Immunotherapy, Erlangen, GermanySearch for more papers by this authorIsaak Effendy, Isaak Effendy Department of Dermatology Venereology and Allergology, University Hospital – Medical School OWL – University of Bielefeld, Bielefeld, GermanySearch for more papers by this authorBeate Schwarz, Beate Schwarz Practice Dr. Med. Beate Schwarz, Langenau, GermanySearch for more papers by this authorChristiane Handrick, Christiane Handrick Practice Dr. Med. Christiane Handrick, Berlin, GermanySearch for more papers by this authorAndrea Asmussen, Andrea Asmussen Practice Dr. Med. Andrea Asmussen, Dermatology at Lesum, Bremen, GermanySearch for more papers by this authorStephan Weidinger, Stephan Weidinger Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, GermanySearch for more papers by this authorJochen Schmitt, Jochen Schmitt Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, GermanySearch for more papers by this authorThomas Werfel, Thomas Werfel Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, GermanySearch for more papers by this authorthe TREATgermany study group, the TREATgermany study groupSearch for more papers by this author Stephan Traidl, Corresponding Author Stephan Traidl [email protected] orcid.org/0000-0003-4806-599X Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany Correspondence Stephan Traidl, Department of Dermatology and Allergy, Hannover Medical School (MHH), Carl-Neuberg-Str.1, 30625 Hannover, Germany. Email: [email protected]Search for more papers by this authorLuise Heinrich, Luise Heinrich Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, GermanySearch for more papers by this authorDoreen Siegels, Doreen Siegels orcid.org/0000-0002-4049-9120 Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, GermanySearch for more papers by this authorAnnice Heratizadeh, Annice Heratizadeh orcid.org/0000-0002-9231-9865 Department of Dermatology and Allergy, Hannover Medical School, Hannover, GermanySearch for more papers by this authorBarbara Kind, Barbara Kind Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, GermanySearch for more papers by this authorEva Haufe, Eva Haufe Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, GermanySearch for more papers by this authorSusanne Abraham, Susanne Abraham orcid.org/0000-0001-7457-6481 Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, GermanySearch for more papers by this authorThomas Schäfer, Thomas Schäfer Practice Dr. Med. Thomas Schaefer/Dr. Med. Doreen Belz, Derma Koeln, Köln, GermanySearch for more papers by this authorMatthias Augustin, Matthias Augustin orcid.org/0000-0002-4026-8728 Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf, Hamburg, GermanySearch for more papers by this authorInken Harder, Inken Harder Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, GermanySearch for more papers by this authorAndreas Pinter, Andreas Pinter orcid.org/0000-0002-1330-1502 Department of Dermatology, Venereology and Allergology, Clinical Research, University Hospital Frankfurt am Main, Frankfurt am Main, GermanySearch for more papers by this authorKnut Schäkel, Knut Schäkel orcid.org/0000-0001-6344-7799 Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, GermanySearch for more papers by this authorAndreas Wollenberg, Andreas Wollenberg orcid.org/0000-0003-0177-8722 Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany Department of Dermatology and Allergy, University Hospital Augsburg, Augsburg, Germany Comprehensive Center for Inflammation Medicine, University of Luebeck, Luebeck, GermanySearch for more papers by this authorKonstantin Ertner, Konstantin Ertner Practice Dr. Med. Konstantin Ertner, Nuernberg, GermanySearch for more papers by this authorJutta Ramaker-Brunke, Jutta Ramaker-Brunke Practice 'Die Hautärzte' Braunschweig, Braunschweig, GermanySearch for more papers by this authorAnne Bong, Anne Bong Practice Dr. Med. Anne Bong, Emmerich, GermanySearch for more papers by this authorSven Quist, Sven Quist Dermatology Clinic, Helix Medical Excellence Center Mainz, Mainz, GermanySearch for more papers by this authorHannah Gorriahn-Maiterth, Hannah Gorriahn-Maiterth Practice Dermasana Karlsruhe, Karlsruhe, GermanySearch for more papers by this authorFlorian Schenck, Florian Schenck Dermatology Center Hannover, Hannover, GermanySearch for more papers by this authorMichael Sticherling, Michael Sticherling Department of Dermatology, University, German Center for Immunotherapy, Erlangen, GermanySearch for more papers by this authorIsaak Effendy, Isaak Effendy Department of Dermatology Venereology and Allergology, University Hospital – Medical School OWL – University of Bielefeld, Bielefeld, GermanySearch for more papers by this authorBeate Schwarz, Beate Schwarz Practice Dr. Med. Beate Schwarz, Langenau, GermanySearch for more papers by this authorChristiane Handrick, Christiane Handrick Practice Dr. Med. Christiane Handrick, Berlin, GermanySearch for more papers by this authorAndrea Asmussen, Andrea Asmussen Practice Dr. Med. Andrea Asmussen, Dermatology at Lesum, Bremen, GermanySearch for more papers by this authorStephan Weidinger, Stephan Weidinger Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, GermanySearch for more papers by this authorJochen Schmitt, Jochen Schmitt Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, GermanySearch for more papers by this authorThomas Werfel, Thomas Werfel Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, GermanySearch for more papers by this authorthe TREATgermany study group, the TREATgermany study groupSearch for more papers by this author First published: 28 March 2024 https://doi.org/10.1111/jdv.19979 Stephan Weidinger, Jochen Schmitt and Thomas Werfel are considered as equally contributing senior authors Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat Open Research DATA AVAILABILITY STATEMENT The data that support the findings of this study are available from the corresponding author upon reasonable request. REFERENCES 1Wollenberg A, Christen-Zäch S, Taieb A, Paul C, Thyssen JP, de Bruin-Weller M, et al. ETFAD/EADV eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children. J Eur Acad Dermatol Venereol. 2020; 34(12): 2717–2744. 10.1111/jdv.16892 CASPubMedWeb of Science®Google Scholar 2Traidl S, Heratizadeh A. Modern systemic therapies for atopic dermatitis: which factors determine the choice of therapy? Dermatologie (Heidelb). 2022; 73(7): 529–537. 10.1007/s00105-022-05003-7 PubMedGoogle Scholar 3Bieber T. Atopic dermatitis: an expanding therapeutic pipeline for a complex disease. Nat Rev Drug Discov. 2022; 21(1): 21–40. 10.1038/s41573-021-00266-6 CASPubMedWeb of Science®Google Scholar 4Traidl S, Freimooser S, Werfel T. Janus kinase inhibitors for the therapy of atopic dermatitis. Allergologie. 2021; 44(9): 710–723. 10.5414/ALX02272 Google Scholar 5Reich K, Kabashima K, Peris K, Silverberg JI, Eichenfield LF, Bieber T, et al. Efficacy and safety of Baricitinib combined with topical corticosteroids for treatment of moderate to severe atopic dermatitis: a randomized clinical trial. JAMA Dermatol. 2020; 156(12): 1333–1343. 10.1001/jamadermatol.2020.3260 PubMedWeb of Science®Google Scholar 6Heratizadeh A, Haufe E, Stölzl D, Abraham S, Heinrich L, Kleinheinz A, et al. Baseline characteristics, disease severity and treatment history of patients with atopic dermatitis included in the German AD registry TREATgermany. J Eur Acad Dermatol Venereol. 2020; 34(6): 1263–1272. 10.1111/jdv.16078 CASPubMedWeb of Science®Google Scholar 7Traidl S, Heinrich L, Siegels D, Rösner L, Haufe E, Harder I, et al. High recurrence rate of eczema herpeticum in moderate/severe atopic dermatitis-TREATgermany registry analysis. J Dtsch Dermatol Ges. 2023; 21(12): 1490–1498. 10.1111/ddg.15205_g Google Scholar 8Williams HC, Burney PG, Hay RJ, Archer CB, Shipley MJ, Hunter JJ, et al. The U.K. working Party's diagnostic criteria for atopic dermatitis. I. Derivation of a minimum set of discriminators for atopic dermatitis. Br J Dermatol. 1994; 131(3): 383–396. 10.1111/j.1365-2133.1994.tb08530.x CASPubMedWeb of Science®Google Scholar 9Williams HC, Jburney PG, Strachan D, Hay RJ. The U.K. Working Party's diagnostic criteria for atopic dermatitis. II. Observer variation of clinical diagnosis and signs of atopic dermatitis. 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Background: There are conflicting data on a potential association between obesity and atopic dermatitis (AD). The purpose of this study was to investigate the relationship between obesity and AD disease severity. Methods: Patients from the TREATgermany registry cohort were divided into three groups according to their body mass index (BMI). Due to low numbers, underweight patients (BMI <18.5 kg/m(2)) were excluded from the analysis. Physician- and patient-reported disease severity scores as well as additional phenotypic characteristics were evaluated for association with BMI. Generalized linear mixed models and multinomial logit models, respectively, were applied to investigate the association of BMI, age, sex and current systemic AD treatment with disease severity. Results: This study encompassed 1416 patients, of which 234 (16.5%) were obese (BMI >= 30 kg/m(2)). Obesity was associated with lower educational background and smoking. Otherwise, obese and non-obese AD patients had similar baseline characteristics. Increased BMI was associated with higher oSCORAD (adjusted beta: 1.24, 95% CI: 1.05-1.46, p = 0.013) and Patient-oriented eczema measure (POEM) (adjusted beta: 1.09, 95% CI: 1.01-1.17, p = 0.038). However, the absolute difference in the overall oSCORAD was small between obese and non-obese AD patients (Delta oSCORAD = 2.5). Allergic comorbidity was comparable between all three groups, with the exception of asthma which was more pronounced in obese patients (p < 0.001). Discussion: In this large and well-characterized AD patient cohort, obesity is significantly associated with physician- and patient-assessed measures of AD disease severity. However, the corresponding effect sizes were low and of questionable clinical relevance. The overall prevalence of obesity among the German AD patients was lower than in studies on other AD cohorts from different countries, which confirms previous research on the German population and suggests regional differences in the interdependence of AD and obesity prevalence.

ZusammenfassungHintergrundTREATgermany ist ein multizentrisches Register, das Patienten mit moderater bis schwerer atopischer Dermatitis (AD) aus derzeit 74 Studienzentren (Universitätskliniken, Krankenhäuser und Praxen) in Deutschland umfasst. Bis zum 31. August 2021 wurden 1.230 erwachsene Patienten eingeschlossen.MethodenIn TREATgermany füllen Patienten und Ärzte Fragebögen zu Symptomen, Krankheitsschwere, Lebensqualität, Depressivität und Fatigue aus. Die Einschränkungen der Arbeitsleistung werden insbesondere mit dem Work Limitations Questionnaire (WLQ) erfasst. Um Assoziationen zwischen beruflicher Leistung/Arbeitseinschränkungen und Symptomen zu bestimmen, wurden Korrelationen und Regressionsmodelle berechnet.ErgebnisseDie untersuchte Stichprobe von 228 berufstätigen Patienten beschrieb einen durchschnittlichen Produktivitätsverlust von 6% bei der Arbeit innerhalb der letzten zwei Wochen vor der Aufnahme in das Register. Der WLQ‐Wert für den Produktivitätsverlust war moderat mit Juckreiz (r = 0,32) und Schlafstörungen (r = 0,39) und stark mit depressiven Symptomen (r = 0,68) und Fatigue (r = 0,60) korreliert.SchlussfolgerungenDie Analysen der Registerdaten zeigen, dass eine moderate bis schwere AD einen negativen Einfluss auf die Arbeitsproduktivität der Patienten hat. Die Analysen weisen außerdem auf die relevanten Zusammenhänge zwischen Arbeitsproduktivität, depressiven Symptomen und Fatigue hin, was die durch die psychologischen Komponenten der AD verursachte Krankheitslast verdeutlicht.

BackgroundTREATgermany is a multicenter registry including patients with moderate-to-severe atopic dermatitis (AD) from currently 74 study centers (university clinics, hospitals and practices) in Germany. As of August 31, 2021, 1,230 adult patients were enrolled. MethodsIn TREATgermany, patients and physicians fill in questionnaires pertaining to symptoms, disease severity, quality of life, depressiveness, and fatigue. In particular, limitations in work performance are assessed using the Work Limitations Questionnaire (WLQ). To assess associations between occupational performance/work limitations and symptoms, correlations and regression models were calculated. ResultsThe examined sample of 228 employed patients reported an average of 6% at-work productivity loss within the past two weeks prior to enrolment in the registry. The WLQ productivity loss score was moderately associated with itch (r = 0.32) and sleep loss (r = 0.39) and strongly associated with depressive symptoms (r = 0.68) and fatigue (r = 0.60). ConclusionsThe analyses of the registry data show that moderate-to-severe atopic dermatitis has a negative impact on the work productivity of the patients. The analyses further point out the relevant associations between work productivity, depressive symptoms, and fatigue highlighting the disease burden caused by the psychological components of AD.