Topical Treatments in Atopic Dermatitis: An Expansive Review

Area of Science:

• Dermatology
• Clinical Trials
• Health Economics

Background:

• Atopic dermatitis (AD) is a prevalent global inflammatory skin condition.
• AD significantly impacts patient quality of life (QoL) and incurs substantial lifetime healthcare costs.
• The pathogenesis of AD involves epidermal barrier dysfunction and hypersensitivity.

Purpose of the Study:

• To review randomized controlled trials (RCTs) of topical therapies for atopic dermatitis since 1990.
• To identify common treatments and efficacy assessment tools used in AD clinical trials.
• To highlight gaps in research regarding the simultaneous evaluation of efficacy, QoL, and cost.

Main Methods:

• Systematic review of 207 randomized controlled trials (RCTs) on topical AD treatments.
• Analysis of trial characteristics, including patient enrollment and treatment arms.
• Identification of commonly used efficacy outcome measures (e.g., EASI, IGA, SCORAD, PGA).

Main Results:

• A wide range of topical therapies were evaluated, including corticosteroids, calcineurin inhibitors, JAK inhibitors, and phosphodiesterase inhibitors.
• Efficacy was primarily assessed using tools such as EASI, IGA, SCORAD, and PGA.
• A significant lack of data exists for trials simultaneously assessing treatment efficacy, patient QoL, and financial cost.

Conclusions:

• Current research on topical AD treatments often fails to integrate efficacy, QoL, and cost-effectiveness.
• There is a critical need for comprehensive clinical trials that evaluate these multiple dimensions.
• Such trials are essential for guiding personalized treatment decisions and optimizing AD management strategies.