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Comparison of the Simple Patient-Centric Atopic Dermatitis Scoring System PEST with SCORAD in Young Children Using a
Mark Jean-Ann Koh1, Yoke Chin Giam2, Hui Min Liew1
1KK Women's and Children's Hospital, Bukit Timah, Singapore, Singapore.
Insights
The Patient Eczema Severity Time (PEST) score shows a moderate correlation with the SCORAD scale in children with atopic dermatitis. PEST may be more sensitive in detecting changes in eczema severity over time.
Area of Science:
- Dermatology
- Clinical Trials
- Patient-Reported Outcomes
Background:
- Atopic dermatitis (AD) management often relies on clinician-assessed scales like SCORAD.
- Patient Eczema Severity Time (PEST) is a novel patient-reported outcome measure for AD.
- PEST aims to capture daily eczema experience, enhancing patient engagement and treatment adherence.
Purpose of the Study:
- To evaluate the correlation between carer-assessed PEST and clinician-assessed SCORAD in pediatric AD patients.
- To assess the efficacy and safety of a ceramide-dominant moisturizer over 12 weeks.
- To determine the responsiveness of PEST compared to SCORAD in measuring AD severity changes.
Main Methods:
- A prospective, open-label, multi-center study involving 58 children (6 months to 6 years) with mild-to-moderate AD.
- Patients used a ceramide-dominant therapeutic moisturizer twice daily for 12 weeks.
- Correlation between 7-day averaged PEST and SCORAD scores was analyzed using a general linear model.
Main Results:
- A moderate correlation (r=0.51) was observed between PEST and SCORAD scores at 12 weeks.
- Both SCORAD and PEST scores showed significant improvement from baseline (p<0.0001).
- PEST demonstrated higher responsiveness to change (33.3% of scale) compared to SCORAD (13.8% of scale).
Conclusions:
- PEST scores correlate well with SCORAD scores in pediatric AD.
- PEST may offer improved sensitivity for detecting AD severity fluctuations.
- The ceramide-dominant moisturizer proved safe and effective for managing pediatric AD.
Introduction:
Patient eczema severity time (PEST) is a new atopic dermatitis (AD) scoring system based on patients' own perception of their disease. Conventional scales such as SCORing of atopic dermatitis (SCORAD) reflect the clinician's observations during the clinic visit. Instead, the PEST score captures eczema severity, relapse and recovery as experienced by the patient or caregiver on a daily basis, promoting patient engagement, compliance with treatment and improved outcomes. This study aims to determine the correlation between carer-assessed PEST and clinician-assessed SCORAD in paediatric AD patients after 12 weeks of treatment using a ceramide-dominant therapeutic moisturizer.
Methods:
Prospective, open-label, observational, multi-centre study in which children with AD aged 6 months to 6 years were treated with a ceramide dominant therapeutic moisturizer twice daily for 12 weeks; 58 children with mild-to-moderate AD were included. Correlation between the 7-day averaged PEST and SCORAD scores for assessment of AD severity was measured within a general linear model. PEST and SCORAD were compared in week 4 and week 12.
Results:
At week 12, a moderate correlation was found between the SCORAD and PEST scores (r = 0.51). The mean change in SCORAD and PEST scores from baseline to week 12 was -11.46 [95% confidence interval (CI) -14.99 to -7.92, p < 0.0001] and -1.33 (95% CI -0.71 to -0.10, p < 0.0001) respectively. PEST demonstrated greater responsiveness to change (33.3% of scale) compared to SCORAD (13.8% of scale).
Conclusion:
The PEST score correlates well with the SCORAD score and may have improved sensitivity when detecting changes in the severity of AD. The ceramide-dominant therapeutic moisturizer used was safe and effective in the management of AD in young children.
Funding:
Hyphens Pharma Pte Ltd.
Trial Registration:
clinicaltrials.gov identifier, NCT02073591.
