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The Correlation Between Atopic Dermatitis Disease Severity and Quality of Life is Complex
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The Correlation Between Atopic Dermatitis Disease Severity and Quality of Life is Complex F. C. Lewer1, K. Keat1,2, P. K. Burton1,2, B. S. Frankum1,2, B. Wainstein3,2, C. H. Katelaris1,2; 1University of Western Sydney, Sydney, AUSTRALIA, 2Sydney South West Area Health Service, Sydney, AUSTRALIA, 3Sydney Children’s Hospital, Sydney, AUSTRALIA. RATIONALE: This study aims to assess whether atopic dermatitis disease severity (as assessed by the SCORing Atopic Dermatitis [SCORAD] assessment tool) is a good indicator of the impact on quality of life (QOL) in the paediatric population. METHODS: Children aged between 2 and 17 years of age that present to the Paediatric Immunology Clinic at Campbelltown Hospital in Sydney, Australia, with atopic dermatitis are assessed using the SCORAD and the PedsQL QOL survey as part of clinical practice. The PedsQL is a general non disease-specific QOL assessment tool. Children are reassessed at subsequent visits and tracked longitudinally. This study is an audit of this data. RESULTS: Preliminary findings for 31 children suggest there is not a strong correlation between disease severity and QOL. Overall correlation between SCORAD and QOL is lower than expected (r5-0.382, p50.11). Visits with children under the age of 5 (n512) have a greater correlation between their SCORAD and QOL scores (r5-0.624, p50.03) than visits of children aged 5 years old or above (n532) (r5-0.304, p50.09, not statistically significant). Surprisingly, there was a trend for visits of children with a SCORAD of 40 or less (n522) to have an almost absent correlation between SCORAD and QOL (r50.059) although this was not statistically significant (p50.795). Those with a SCORAD over 40 (n522) have a strong negative correlation (r5-0.516, p50.014). CONCLUSIONS: This preliminary data indicates a complex relationship between disease severity and effects on QOL, in the setting of atopic dermatitis. This relationship may become more evident as we examine a larger sample size.
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Effect of Fluticasone/Salmeterol on Sleep Quality in Patients with COPD E. M. Banta, C. Mende, C. Rhoads, T. J. Craig; Penn State Milton S. Hershey Medical Center, Hershey, PA. RATIONALE: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States. Characterized by dyspnea and reduced FEV1, this disease is also commonly associated with sleep disturbance and daytime sleepiness. The purpose of this study was to determine if treatment with fluticasone/salmeterol would improve sleep disturbance. METHODS: After IRB approval, a double-blind crossover protocol was used to treat subjects with moderate to severe COPD with fluticasone/salmeterol. Sleep quality and daytime sleepiness were assessed using sleep questionnaires and actigraphy watch data. RESULTS: A total of 15 patients with moderate-severe COPD by GOLD criteria participated in the study. FEV1 improved in patients treated with fluticasone/salmeterol (p<0.001). No change was seen in actigraphy data. Functional outcome of sleep quality assessment (FOSQ) revealed improvement (p50.021). However, no changes between groups were seen with the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Instrument (PSQI), Calgary Sleep Apnea Quality of Life (SAQLI) or a daily sleep diary. CONCLUSIONS: Treatment with fluticasone/salmeterol led to improvement in FEV1 and other spirometric parameters. The FOSQ revealed improvement in sleep quality and may be a more sensitive tool for sleep quality assessment in patients with COPD. Changes in daytime sleepiness were not detected. These results underscore that sleep disturbance associated with COPD is multifactorial and that improving FEV1 is only one step toward improving overall sleep quality and perceived daytime sleepiness.
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A Pediatric Food Allergy Support Group Can Improve Parent and Physician Communication: Results of a Parent Survey A. P. Sharma, T. Prematta, T. Fausnight; Hershey Medical Center-Penn State University, Hershey, PA. RATIONALE: Food allergies have a significant impact on quality of life. We sought to evaluate the impact of a food allergy support group (FASG) on quality of life and the relationship between parents and their child’s allergist. METHODS: After IRB approval, 98 online surveys were sent to parents who attend a FASG affiliated with our institution. Responses were analyzed looking for reasons for attending the support group, parent satisfaction, and comfort with having an allergist present at the meetings. RESULTS: A total of 29 surveys (29.6%) were completed. The majority of respondents (96.4%) joined the FASG to ‘feel more knowledgeable about food allergies’. The FASG decreased anxiety about food allergies for 77.7% of those who responded. Most (71.4%) felt the FASG improved their child’s quality of life. Greater than 90% felt comfortable having an allergist at the support group meeting, and 64.3% felt that talking to an allergist at the FASG made it easier to speak with their child’s allergist. Many of the respondents (77.8%) said they would continue to attend the support group meetings. CONCLUSIONS: FASG meetings appear to be a good way for families of children with food allergies to learn more about food allergies and become comfortable with their child’s diagnosis. Participating in FASG meetings can also improve quality of life and increase comfort in communicating with their child’s allergist.
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Efficacy and Tolerability of Levocetirizine in Improving Symptoms and Health-Related Quality of Life in Patients with Allergic Rhinitis: A Meta-Analysis R. Khianey, M. E. Weinstein; Division of Allergy, Immunology, and Rheumatology, University of Medicine and Dentistry of New JerseyNew Jersey Medical School, Newark, NJ. RATIONALE: Randomized controlled trials have reviewed levocetirizine for allergic rhinitis (AR). A meta-analysis was conducted assessing its efficacy in improving symptoms and quality of life in patients with AR. METHODS: The literature was searched using MEDLINE from 1996 through August 2010. Double-blinded, randomized, and placebo-controlled studies were included comparing levocetirizine vs placebo in patients with AR. RESULTS: Overall, 2,194 patients were identified from 5 included studies. The primary endpoint was the percent change in Total 5 or 4 Symptom Score (T5SS/T4SS) at 2 weeks. Secondary assessments included the percent change in T5SS/T4SS at 4 weeks and the percent change in overall Rhinoconjunctivitis Quality of Life Questionnaire or Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score at end of treatment. Results were converted to reflect the percent change in symptom scores before and after therapy. Safety assessments were based on adverse events. Four trials demonstrated improvement in the T5SS/T4SS in two weeks with levocetirizine vs placebo (mean difference [MD], -8%, 95% CI -8.1%, -7.9%). Three trials indicated that levocetirizine improves the T5SS/T4SS at four weeks vs placebo (MD, -12%, 95% CI -12.1%, -11.9%). Three trials demonstrated significant reduction in the RQLQ score with levocetirizine vs placebo (MD, -15% 95% CI -16%, -14%). None of the studies found an increased rate of adverse events (OR, 1.04; 95% CI, 0.78 to 1.38). CONCLUSIONS: This meta-analysis suggests levocetirizine is effective in the treatment of AR by reducing the T5SS/T4SS and RQLQ score. Levocetirizine is well tolerated, but likely functions best in combination with other treatment modalities.
SATURDAY
Abstracts AB43
J ALLERGY CLIN IMMUNOL VOLUME 127, NUMBER 2
The Correlation Between Atopic Dermatitis Disease Severity and Quality of Life is Complex F. C. Lewer1, K. Keat1,2, P. K. Burton1,2, B. S. Frankum1,2, B. Wainstein3,2, C. H. Katelaris1,2; 1University of Western Sydney, Sydney, AUSTRALIA, 2Sydney South West Area Health Service, Sydney, AUSTRALIA, 3Sydney Children’s Hospital, Sydney, AUSTRALIA. RATIONALE: This study aims to assess whether atopic dermatitis disease severity (as assessed by the SCORing Atopic Dermatitis [SCORAD] assessment tool) is a good indicator of the impact on quality of life (QOL) in the paediatric population. METHODS: Children aged between 2 and 17 years of age that present to the Paediatric Immunology Clinic at Campbelltown Hospital in Sydney, Australia, with atopic dermatitis are assessed using the SCORAD and the PedsQL QOL survey as part of clinical practice. The PedsQL is a general non disease-specific QOL assessment tool. Children are reassessed at subsequent visits and tracked longitudinally. This study is an audit of this data. RESULTS: Preliminary findings for 31 children suggest there is not a strong correlation between disease severity and QOL. Overall correlation between SCORAD and QOL is lower than expected (r5-0.382, p50.11). Visits with children under the age of 5 (n512) have a greater correlation between their SCORAD and QOL scores (r5-0.624, p50.03) than visits of children aged 5 years old or above (n532) (r5-0.304, p50.09, not statistically significant). Surprisingly, there was a trend for visits of children with a SCORAD of 40 or less (n522) to have an almost absent correlation between SCORAD and QOL (r50.059) although this was not statistically significant (p50.795). Those with a SCORAD over 40 (n522) have a strong negative correlation (r5-0.516, p50.014). CONCLUSIONS: This preliminary data indicates a complex relationship between disease severity and effects on QOL, in the setting of atopic dermatitis. This relationship may become more evident as we examine a larger sample size.
154
Effect of Fluticasone/Salmeterol on Sleep Quality in Patients with COPD E. M. Banta, C. Mende, C. Rhoads, T. J. Craig; Penn State Milton S. Hershey Medical Center, Hershey, PA. RATIONALE: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States. Characterized by dyspnea and reduced FEV1, this disease is also commonly associated with sleep disturbance and daytime sleepiness. The purpose of this study was to determine if treatment with fluticasone/salmeterol would improve sleep disturbance. METHODS: After IRB approval, a double-blind crossover protocol was used to treat subjects with moderate to severe COPD with fluticasone/salmeterol. Sleep quality and daytime sleepiness were assessed using sleep questionnaires and actigraphy watch data. RESULTS: A total of 15 patients with moderate-severe COPD by GOLD criteria participated in the study. FEV1 improved in patients treated with fluticasone/salmeterol (p<0.001). No change was seen in actigraphy data. Functional outcome of sleep quality assessment (FOSQ) revealed improvement (p50.021). However, no changes between groups were seen with the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Instrument (PSQI), Calgary Sleep Apnea Quality of Life (SAQLI) or a daily sleep diary. CONCLUSIONS: Treatment with fluticasone/salmeterol led to improvement in FEV1 and other spirometric parameters. The FOSQ revealed improvement in sleep quality and may be a more sensitive tool for sleep quality assessment in patients with COPD. Changes in daytime sleepiness were not detected. These results underscore that sleep disturbance associated with COPD is multifactorial and that improving FEV1 is only one step toward improving overall sleep quality and perceived daytime sleepiness.
155
A Pediatric Food Allergy Support Group Can Improve Parent and Physician Communication: Results of a Parent Survey A. P. Sharma, T. Prematta, T. Fausnight; Hershey Medical Center-Penn State University, Hershey, PA. RATIONALE: Food allergies have a significant impact on quality of life. We sought to evaluate the impact of a food allergy support group (FASG) on quality of life and the relationship between parents and their child’s allergist. METHODS: After IRB approval, 98 online surveys were sent to parents who attend a FASG affiliated with our institution. Responses were analyzed looking for reasons for attending the support group, parent satisfaction, and comfort with having an allergist present at the meetings. RESULTS: A total of 29 surveys (29.6%) were completed. The majority of respondents (96.4%) joined the FASG to ‘feel more knowledgeable about food allergies’. The FASG decreased anxiety about food allergies for 77.7% of those who responded. Most (71.4%) felt the FASG improved their child’s quality of life. Greater than 90% felt comfortable having an allergist at the support group meeting, and 64.3% felt that talking to an allergist at the FASG made it easier to speak with their child’s allergist. Many of the respondents (77.8%) said they would continue to attend the support group meetings. CONCLUSIONS: FASG meetings appear to be a good way for families of children with food allergies to learn more about food allergies and become comfortable with their child’s diagnosis. Participating in FASG meetings can also improve quality of life and increase comfort in communicating with their child’s allergist.
156
Efficacy and Tolerability of Levocetirizine in Improving Symptoms and Health-Related Quality of Life in Patients with Allergic Rhinitis: A Meta-Analysis R. Khianey, M. E. Weinstein; Division of Allergy, Immunology, and Rheumatology, University of Medicine and Dentistry of New JerseyNew Jersey Medical School, Newark, NJ. RATIONALE: Randomized controlled trials have reviewed levocetirizine for allergic rhinitis (AR). A meta-analysis was conducted assessing its efficacy in improving symptoms and quality of life in patients with AR. METHODS: The literature was searched using MEDLINE from 1996 through August 2010. Double-blinded, randomized, and placebo-controlled studies were included comparing levocetirizine vs placebo in patients with AR. RESULTS: Overall, 2,194 patients were identified from 5 included studies. The primary endpoint was the percent change in Total 5 or 4 Symptom Score (T5SS/T4SS) at 2 weeks. Secondary assessments included the percent change in T5SS/T4SS at 4 weeks and the percent change in overall Rhinoconjunctivitis Quality of Life Questionnaire or Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score at end of treatment. Results were converted to reflect the percent change in symptom scores before and after therapy. Safety assessments were based on adverse events. Four trials demonstrated improvement in the T5SS/T4SS in two weeks with levocetirizine vs placebo (mean difference [MD], -8%, 95% CI -8.1%, -7.9%). Three trials indicated that levocetirizine improves the T5SS/T4SS at four weeks vs placebo (MD, -12%, 95% CI -12.1%, -11.9%). Three trials demonstrated significant reduction in the RQLQ score with levocetirizine vs placebo (MD, -15% 95% CI -16%, -14%). None of the studies found an increased rate of adverse events (OR, 1.04; 95% CI, 0.78 to 1.38). CONCLUSIONS: This meta-analysis suggests levocetirizine is effective in the treatment of AR by reducing the T5SS/T4SS and RQLQ score. Levocetirizine is well tolerated, but likely functions best in combination with other treatment modalities.
SATURDAY
Abstracts AB43
J ALLERGY CLIN IMMUNOL VOLUME 127, NUMBER 2