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8 Clinical Experience in Adults
Table 8.2. The EASI and mEASI criteria
Steps used to generate scores
Scores assigned
To calculate the EASI
Severity of the four signs of atopic dermatitis (erythema, lichenification,
oedema/induration/papulation, and excoriation) evaluated in four body
regions (head/neck, trunk, upper limbs, and lower limbs)
0–3 per sign
(absent to severe)
Resulting scores in each body region for each sign of atopic dermatitis are 0–12 per sign
combined to give a total regional score
Body surface area (BSA) affected is scored for each of the four regions
(head/neck, trunk, upper limbs, and lower limbs)
0–6 per sign
(where '0' equals none
of the body affected
and '6' represents
90%–100% affected)
For each body region, the total regional score is multiplied by the score
for affected BSA
Regional score (0–12)
× affected BSA (0–6)
The number calculated in the last equation is multiplied by a weighted
constant for each body region and combined with scores from the
remaining three regions
0–72 (EASI score)
To calculate the mEASI
Patient's assessment of pruritus
0–3
Pruritus score (0–3) is multiplied by the affected BSA score (0–6) for each
of the four body regions (head/neck, trunk, upper limbs, and lower limbs)
0–18
Scores for each body region are combined with the weighting system used
to calculate the EASI. The total score (0–18) is added to the EASI score
0–90
■The concept of area-under-the-concentration-time curve (mEASI AUC), expres-
sed as a percentage of the baseline mEASI score, was used to show the degree to
which the burden of atopic dermatitis was reduced by the study treatment. This
is important because atopic dermatitis is a disease of fluctuating severity, and it
is only by assessing the presence and absence of disease throughout a treatment
period that a complete assessment of the level of control can be obtained.
■The physician’s global evaluation of clinical response. Here the physician rated
the response to the treatment within one of seven categories from worse (<0),
through no appreciable improvement (0%–29%), slight improvement (30%–
49%), moderate improvement (50%–74%), marked improvement (75%–89%), excellent improvement (90%–99%) and cleared (100%).
■The physician’s estimation of the percentage of BSA affected by eczematous lesions. The percentage of each body region (head/neck, trunk, upper limbs, and
lower limbs) affected by atopic dermatitis was calculated separately and a total
percentage was derived from the same weighting procedure as that used for the
EASI.
136
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