Many Patients With Eczema Consider a Clinical Trial, but Few Enroll

Limited participation in clinical trials among adult patients with eczema may result from lack of awareness, lack of interest, or barriers to enrollment, according to an observation study published in Acta Dermato-Venereologica.

The study researchers said investigational therapies from clinical trials can provide new opportunities and options for patients with recalcitrant disease, better align with patient treatment preferences, address unmet needs, and advance medical knowledge.

“Recent advances in understanding the pathophysiology of eczema have resulted in an unprecedented increase in the number of eczema clinical trials,” they noted.

But for successful participation to occur, patients must be aware of clinical trials, be motivated to join, and face few or no barriers. It’s unclear how, or if, the results from studies exploring broad awareness and participation in clinical trials apply to patients with eczema, the authors noted. The aim of the present study was to identify factors associated with eczema clinical trial awareness, interest, and barriers to participation.

Eczema is an inflammatory skin condition associated with itchiness, rashes, scaly patches, skin discoloration, blisters, and skin infections. Symptoms are different for everyone. In addition, the recurring and remitting nature of the illness makes it difficult to treat using a one-size-fits-all approach.

There are 7 distinct types of eczema, and of them, atopic dermatitis is the most common form.

The present study, conducted between May 1 and June 6, 2020, enrolled adult patients with eczema; participation was promoted via the National Eczema Association website, e-mail, and social media. Investigators administered an online survey to 800 patients. The population had a mean (SD) age of 49.4 (6.5) years and 78% were female patients. Most participants identified as White (75.4%), non-Hispanic (91.4%,) and living in an urban/suburban area (90.8%).

The researchers divided the study population into 3 subgroups based on previous clinical trial participation or interest:

• Actual clinical trial participation: previous participation in 1 or more clinical trials
• Considered clinical trial participation with/without attempt: no prior participation but an attempt or consideration of participating
• Clinical trial participation consideration/attempt: no prior clinical trial participation and no consideration of participating

They analyzed factors associated with clinical trial awareness, interest, and barriers to participation by comparing responses from the 3 subgroups:

Clinical trial understanding: Certain clinical trial–related terms were poorly understood across all groups. However, there was a significant difference in the composite understanding score of clinical trial–related terminology between the subgroups. Specifically, the no clinical trial participation consideration/attempt group had a lower average composite score compared with the considered (P < .001), tried (P < .001), 1 clinical trial (P < .001), and 3 clinical trial groups (P < .013).

Clinical trial awareness: In a multivariable model, there were no significant differences in gender, race, ethnicity, geography, and eczema severity between the “aware” and “not aware” subgroups. However, those 65 years and older were 54.8 % less likely (95% CI, 30.0%-71.0%; P = .001) to be aware of clinical trials compared with those aged 18 to 35 years. Moreover, patients with a diagnosis of atopic dermatitis were 1.8 times more likely (95% CI, 1.2-2.8; P = .003) to be aware of eczema clinical trials.

Interest in clinical trial participation: The study found significant differences in age (P = .002) between those who were interested in clinical trial participation and those not interested. Further, female patients were 56% less likely (95% CI, 24.8%-73.8%; P = .002) to express interest in clinical trial participation than male patients.

The authors noted that patients who were satisfied with their current eczema therapy were 3 times more likely (95% CI, 1.6-6.1; P < .001) to be interested in clinical trial participation than those who were dissatisfied. They suggested that patients satisfied with their current regimen may be more optimistic about new treatments.

Overall, findings show that few adult patients with eczema have participated in clinical trials (9.7%), yet many (57.1%) have considered it.

One barrier to successful clinical trial participation was lower confidence in knowing where to find information on available eczema clinical trials. Thus, health care providers may be well positioned to be a resource to their patients, the authors concluded. Just 8.7% of their study population reported discussing eczema clinical trials with their provider.

“Awareness may lead to increased clinical trial participation at a critical time when eczema treatment development is booming,” they said.

Reference

Grinich EE, Thibau IJ, Latour E, Price KN, et al. Factors associated with eczema clinical trial awareness, interest, and participation in adults. Acta Dermato-Venereologica. Published online June 20, 2023. doi:10.2340/actadv.v103.6520