Treat-to-Target in Atopic Dermatitis

Area of Science:

• Dermatology
• Clinical Practice
• Treatment Strategies

Background:

• Atopic dermatitis (AD) is a prevalent inflammatory skin disease affecting children and adults.
• Recent advancements have expanded treatment options for AD, including topical and systemic therapies.
• The treat-to-target approach, common in rheumatology, involves setting defined treatment goals within specific timeframes.

Purpose of the Study:

• To evaluate the applicability of treat-to-target strategies for atopic dermatitis in real-world clinical practice.
• To explore the integration of validated tools for measuring treatment effects on comorbidities.
• To address challenges in implementing treat-to-target approaches, such as data collection time.

Main Methods:

• Review of existing treat-to-target frameworks for atopic dermatitis based on Harmonizing Outcome Measure for Eczema (HOME) initiative recommendations.
• Analysis of the inclusion of co-morbidity assessment in current frameworks.
• Discussion of potential solutions, including electronic applications for patient-reported outcomes.

Main Results:

• Current treat-to-target frameworks for AD primarily rely on Eczema Area and Severity Index (EASI) scores, with EASI-75 as a common endpoint.
• Existing frameworks often lack instruments to measure the impact of treatment on patient comorbidities (physical, psychological, socioeconomic).
• Data collection for treat-to-target implementation can be time-consuming in clinical settings.

Conclusions:

• Treat-to-target strategies for atopic dermatitis require adaptation for real-world clinical practice, emphasizing patient-centered goals and shared decision-making.
• Incorporating validated tools for co-morbidity assessment is crucial for a holistic treatment approach.
• Electronic applications may help mitigate data collection burdens, facilitating the implementation of treat-to-target strategies.