Ten specific updates for the Mexican atopic dermatitis guidelines, GUIDAMEX 1.1.

Area of Science:

• Dermatology
• Clinical Practice Guidelines
• Pharmacology

Background:

• The 2022 Mexican Atopic Dermatitis Guideline (GUIDAMEX-2022) was established using the ADAPTE methodology.
• New global drug approvals necessitate timely updates to clinical guidelines for atopic dermatitis (AD).

Purpose of the Study:

• To update the Mexican Atopic Dermatitis Guideline (GUIDAMEX-2022) to GUIDAMEX 1.1.
• To provide evidence-based recommendations and suggestions for managing AD in Mexico, incorporating new treatments and patient-centered goals.

Main Methods:

• Formulation of 10 key clinical questions addressing recent global approvals for AD treatments.
• Systematic review of evidence from updated international guidelines, cost-effectiveness, safety profiles, and the Mexican healthcare context.
• Development of recommendations (R), suggestions (S), and good practice points using the ADAPTE methodology.

Main Results:

• GUIDAMEX 1.1 conditionally suggests tertiary prevention strategies for AD, focusing on preventing allergic comorbidities.
• Recommendations and suggestions are provided for topical treatments (crisaborole, tapinarof, ruxolitinib, roflumilast) and systemic treatments (dupilumab, baricitinib, lebrikizumab, nemolizumab, tralokinumab) with specific age and indication criteria.
• The guideline incorporates patient-defined treatment goals and minimal disease activity targets (EASI-90/100).

Conclusions:

• Advances in atopic dermatitis management allow for more ambitious treatment goals.
• The updated GUIDAMEX provides Mexican clinicians with current indications and dosages for managing AD.
• The guideline emphasizes a comprehensive approach, including prevention, patient-centered goals, and novel therapeutic options.