Treat-to-Target in Atopic Dermatitis: An International Consensus on a Set of Core Decision Points for Systemic Therapies

Marjolein De Bruin-Weller, Tilo Biedermann, Robert Bissonnette, Mette Deleuran, Peter Foley, Giampiero Girolomoni, Jana Hercogová, Chih-Ho Hong, Norito Katoh, Andrew E Pink, Marie-Aleth Richard, Stephen Shumack, Juan F Silvestre, Stephan Weidinger

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Abstract

Currently no treat-to-target framework to guide systemic treatment in adults with moderate-to-severe atopic dermatitis exists. We sought to reach international consensus through an eDelphi process on a core set of recommendations for such an approach. Recommendations were developed by an international Steering Committee, spanning 3 areas (Guiding Principles, Decision Making, and Outcome Thresholds) and 2 specific time-points; an initial acceptable target at 3 months and an optimal target at 6 months, each based on improvements in patient global assessment plus at least one specific outcome domain. These treat-to-target- orientated recommendations were evaluated by an extended international panel of physicians, nurses and patients. Proposed recommendations were rated using a 9-point Likert scale; for each recommendation, consensus agreement was reached if ≥ 75% of all respondents rated agreement as ≥ 7. Consensus on 16 core recommendations was reached over 2 eDelphi rounds. These provide a framework for shared decision-making on systemic treatment continuation, modification, or discontinuation.

Original languageEnglish
Article numberadv00402
Pages (from-to)1-7
JournalActa Dermato-Venereologica
Volume101
Issue number2
DOIs
Publication statusPublished - 17 Feb 2021

Keywords

  • Atopic dermatitis
  • Consensus
  • Edelphi
  • Surveys and questionnaires
  • Systemic treatment
  • Treat-to-target

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