Tool
Source: Campus Sanofi
23 Oct 2023

5 min

Atopic Dermatitis Control Tool (ADCT)

Author: Sanofi

DUPIXENT(dupilumab) Prescribing Information GB

DUPIXENT (dupilumab) Prescribing Information NI/ROI

Introducing ADCT

Atopic Dermatitis Control Tool (ADCT) – a validated, brief and easily scored tool
Six concise questions to evaluate all dimensions of atopic dermatitis (AD) control identified as relevant by patients and clinicians
ADCT can be self-assessed by patients or used in routine consultations
ADCT is designed to help facilitate meaningful patient–physician discussion on control of AD in every day clinical practice, enabling improvements in disease monitoring

Development of ADCT involved interviews with patients as well as physicians. Six main areas were found critical in assessing the multi-dimensional aspects of disease control over the course of a week, and form the basis of ADCT:

*Please note: this link is for HCP reference only to aid understanding of the tool. Please use the following link when sharing it with your patients: Change AD UK: Atopic Dermatitis Patient Support

ADCT Validation

ADCT was rigorously tested with 270 US patients who were clinically diagnosed with AD by a healthcare professional, and were using a prescription treatment for AD within the past 6 months (not including oral antihistamines or oral antibiotics)¹. Two studies confirmed that ADCT is a valid and reliable tool for assessing AD control and that it can be used to detect change of disease activity in a person over time ^1,2.

ADCT is recommended by HOME³

ADCT has been recommended by the Harmonising Outcome Measures for Eczema (HOME) initiative as one of the core instruments for assessing long-term control in atopic dermatitis.³

HOME is a global initiative of healthcare professionals, patients, carers, regulatory bodies, journal editors and the pharmaceutical industry to develop a consensus-based core outcome set for clinical trials. The core outcome set of parameters that are recommended by HOME to be measured in all clinical trials comprises:

Clinician-reported signs of atopic dermatitis
Recommended tool: Eczema Area and Severity Index (EASI)
Patient-reported symptoms
Recommended tools: Patient-Oriented Eczema Measure (POEM) and Numerical Rating Scale (NRS) 11 (for peak itch over past 24h)
Quality of Life
Recommended tools: Dermatology Life Quality Index (DLQI), Children Dermatology Life Quality Index (CDLQI), Infant Dermatology Life Quality Index (IDQoL)
Long-term control of atopic dermatitis
Recommended tools: Recap of atopic eczema (RECAP) and Atopic Dermatitis Control Tool (ADCT)

ADCT Scoring Instructions

To use ADCT correctly, your patient must answer all six ADCT questions by selecting the most appropriate answer.

	0 points	1 point	2 points	3 points	4 points
1. Over the last week, how would you rate your eczema-related symptoms?	None	Mild	Moderate	Severe	Very Severe
2. Over the last week, how many days did you have intense episodes of itching because of your eczema?	Not at all	1-2 days	3-4 days	5-6 days	Everyday
3. Over the last week, how bothered have you been by your eczema?	Not at all	A little	Moderately	Very	Extremely
4. Over the last week, how many nights did you have trouble falling or staying asleep because of your eczema?	No nights	1-2 nights	3-4 nights	5-6 nights	Every night
5. Over the last week, how much did your eczema affect your daily activities?	Not at all	A little	Moderately	A lot	Extremely
6. Over the last week, how much did your eczema affect your mood or emotions?	Not at all	A little	Moderately	A lot	Extremely

Calculating the ADCT Score

Step 1: Each ADCT question is scored 0–4 points, as shown in the table above
Step 2: The sum of the scores from all six ADCT questions forms the ADCT total score
The minimum score is 0, the maximum score is 24

Interpreting the ADCT score

Point in time control status

A higher score indicates lower AD control
A patient's AD may not be well controlled if:

The ADCT total score is at least 7 points

Changes in control status over time

A change of 5 points in the threshold for meaningful within person change

Decrease of 5 points or more: indication of clinically relevant improvement of AD control
Increase of 5 points or more: indication of clinically relevant worsening of AD control

Recommendations for using ADCT in clinical practice

Your patient’s AD may not be well controlled if:

Their ADCT total score is at least 7 points

Their ADCT total score has increased by 5 points or more since they last used ADCT

If you are concerned that your patient’s AD is not well controlled, you might want to initiate further conversations about optimal management of their AD.

*Please note: this link is for HCP reference only to aid understanding of the tool. Please use the following link when sharing it with your patients: Change AD UK: Atopic Dermatitis Patient Support

Development of ADCT involved literature review as well as interviews with patients and physicians, and was funded by Sanofi and Regeneron.

References

David M Pariser et al., Evaluating patient-perceived control of atopic dermatitis: design, validation, and scoring of the Atopic Dermatitis Control Tool (ADCT). Current Medical Research and Opinion 2019. DOI: 10.1080/03007995.2019.1699516
Eric Simpson et al.,. Validation of the Atopic Dermatitis Control Tool (ADCT©) using a longitudinal survey of biologic-treated patients with atopic dermatitis. BMC Dermatology 2019;19:15. DOI: 10.1186/s12895-019-0095-3
http://www.homeforeczema.org/research/long-term-control.aspx. Accessed November 2023

Atopic Dermatitis Control Test (ADCT)

Atopic dermatitis, a type of eczema, may be affecting your patient’s life in more ways than you know.

The ADCT gives a measure of how controlled your patient’s eczema is. Use these 6 concise questions to evaluate all dimensions of atopic dermatitis control.