title: Quality of life in treatment of AK: Treatment burden of ingenol mebutate gel is small and short lasting.
abstract: BACKGROUND
  Treatments for actinic keratosis (AK) can elicit adverse local skin responses (LSRs). Knowledge regarding the burden of AK treatment on health related quality of life (HRQoL) is however limited.
  
  
  OBJECTIVE
  To investigate whether treatment of AK improved HRQoL; to assess whether LSRs had an impact on HRQoL during treatment and to analyze the relationship between LSRs and HRQoL.
  
  
  METHODS
  Patients (n = 329) were randomized for treatment with cryosurgery (CRY) followed by ingenol mebutate (IngMeb) (CRY + IngMeb) or CRY followed by vehicle (CRY + vehicle). HRQoL was analyzed using DLQI, EQ-5D and EQ-VAS at baseline, three days, two weeks and eight weeks post treatment.
  
  
  RESULTS
  Statistically significant HRQoL improvements were seen in all measures in both treatment groups (p < 0.001). Impairments in DLQI in CRY + IngMeb at LSR peak were within a range interpreted as having "a small impact on patients' life" (2-5), which normalized within two weeks.
  
  
  CONCLUSIONS
  DLQI may not be sensitive to change in the AK disease as it mainly captures symptoms and has a limited focus on feelings.
  
  
  CONCLUSIONS
  The treatment burden of IngMeb is small, manageable and short-lasting. Since AK is a chronic condition, often requiring repeated treatment courses, combining treatments that provide enhanced effectiveness, while limiting HRQoL impairment is essential.
authors.affiliation: a Indiana University School of Medicine , Indianapolis , IN , USA ;
authors.forename: William C
authors.initials: WC
authors.lastname: Hanke
authors.affiliation: b LEO Pharma A/S , Ballerup , Denmark ;
authors.forename: Jenny M
authors.initials: JM
authors.lastname: Norlin
authors.affiliation: b LEO Pharma A/S , Ballerup , Denmark ;
authors.forename: Kim
authors.initials: K
authors.lastname: Mark Knudsen
authors.affiliation: b LEO Pharma A/S , Ballerup , Denmark ;
authors.forename: Thomas
authors.initials: T
authors.lastname: Larsson
authors.affiliation: c Division of Dermatology , Southern Illinois University School of Medicine , Springfield , IN , USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Stone
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D003452:Cryosurgery; D004224:Diterpenes / Q000008:administration & dosage / Q000009:adverse effects*; D003875:Drug Eruptions / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D005260:Female; D005782:Gels; D006801:Humans; D055623:Keratosis, Actinic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: C486592:3-ingenyl angelate; D004224:Diterpenes; D005782:Gels
keywords: Actinic keratosis; DLQI; EQ-5D; health related ouality of life; ingenol mebutate gel; local skin responses