What Does Long-Term Control in Atopic Dermatitis Look Like?

What defines long-term control in atopic dermatitis (AD) and why is it difficult to measure in AD? Why does long-term control matter? Herein, we critically examine these questions along with the clinical rationale, approaches for assessing long-term control in clinical practice, potential mechanistic underpinnings for AD long-term control, and evidence for long-term control with current systemic AD treatments. Currently, there is limited consensus on how to define flares and long-term control due to AD's heterogeneous nature, and AD being a disorder largely defined by patients' individual experience. An important part of long-term control is disease modification, which is made up of the impact on the disease itself and also its impact on AD's associated comorbidities. By focusing on the multiple facets of long-term control, possible deep/long-term remission or even therapy free remission may be achieved. While there is some research currently available on the long-term efficacy of current AD therapies, larger studies with longer follow-up periods are needed to adequately determine if reduced dosing can be applied to AD patients who have achieved deep/long-term remission. Future directions in AD may involve developing new therapies that target the innate and adaptive immune systems to bring about disease modification.