Consensus Update for Systemic Treatment of Atopic Dermatitis

Area of Science:

• Dermatology
• Immunology
• Pharmacology

Background:

• The Korean Atopic Dermatitis Association (KADA) previously issued consensus guidelines for atopic dermatitis (AD) treatment in 2015.
• Current medical advancements necessitate updated recommendations for managing AD.

Purpose of the Study:

• To establish updated consensus recommendations for the systemic treatment of atopic dermatitis (AD) in South Korea.
• To incorporate recent evidence and clinical experience into AD management strategies.

Main Methods:

• A comprehensive database of systematic reviews and guidelines on AD systemic management was compiled.
• Evidence grading and classification were performed to determine recommendation strength.
• A consensus was reached through three rounds of voting by 42 KADA council members.

Main Results:

• Long-term systemic steroid use for moderate-to-severe AD is not recommended due to adverse effects.
• Cyclosporine or dupilumab are recommended for moderate-to-severe AD; methotrexate or azathioprine are selective options.
• Narrowband ultraviolet B is recommended for chronic moderate-to-severe AD; oral antibiotics are not recommended without infection signs.
• Antihistamines are suggested for symptom alleviation; consensus was not reached on immunotherapy, probiotics, evening primrose oil, or vitamin D.
• Educational interventions and counseling are recommended for patients and caregivers to enhance treatment success.

Conclusions:

• The updated consensus provides a framework for improved systemic therapy in moderate-to-severe AD.
• Implementation of these recommendations aims to optimize the control of atopic dermatitis.