Treat-to-Target in Atopic Dermatitis: An International Consensus on a Set of Core Decision Points for Systemic Therapies

Overview

Journal Acta Derm Venereol

Specialty Dermatology

Date 2021 Jan 25

PMID 33491094

Citations 40

Authors

Marjolein de Bruin-Weller

Tilo Biedermann

Robert Bissonnette

Mette Deleuran

Peter Foley

Giampiero Girolomoni

Jana Hercogova

Chih-Ho Hong

Norito Katoh

Andrew E Pink

Marie-Aleth Richard

Stephen Shumack

Juan F Silvestre

Stephan Weidinger

Affiliations

Soon will be listed here.

Abstract

Currently no treat-to-target framework to guide systemic treatment in adults with moderate-to-severe atopic dermatitis exists. We sought to reach international consensus through an eDelphi process on a core set of recommendations for such an approach. Recommendations were developed by an international Steering Committee, spanning 3 areas (Guiding Principles, Decision Making, and Outcome Thresholds) and 2 specific time-points; an initial acceptable target at 3 months and an optimal target at 6 months, each based on improvements in patient global assessment plus at least one specific outcome domain. These treat-to-target- orientated recommendations were evaluated by an extended international panel of physicians, nurses and patients. Proposed recommendations were rated using a 9-point Likert scale; for each recommendation, consensus agreement was reached if ≥ 75% of all respondents rated agreement as ≥ 7. Consensus on 16 core recommendations was reached over 2 eDelphi rounds. These provide a framework for shared decision-making on systemic treatment continuation, modification, or discontinuation.

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