Treat-to-Target in Atopic Dermatitis: An International Consensus on a Set of Core Decision Points for Systemic Therapies
Por:
De Bruin-Weller, M, Biedermann, T, Bissonnette, R, Deleuran, M, Foley, P, Girolomoni, G, Hercogova, J, Hong, C, Katoh, N, Pink, A, Richard, M, Shumack, S, Silvestre, J and Weidinger, S
Publicada:
1 feb 2021
Resumen:
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 Steerng 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.
Filiaciones:
De Bruin-Weller, M:
UMC Utrecht, Dept Allergol & Dermatol, Natl Expertise Ctr Eczema, NL-3584 Utrecht, Netherlands
Biedermann, T:
Tech Univ Munich, Dept Dermatol & Allergy, Munich, Germany
Bissonnette, R:
Innovaderm Res, Montreal, PQ, Canada
Deleuran, M:
Aarhus Univ Hosp, Dept Dermatol & Venereol, Aarhus, Denmark
Foley, P:
St Vincents Hosp Melbourne, Univ Melbourne, Melbourne, Vic, Australia
Skin Hlth Inst, Prob Med Res, Melbourne, Vic, Australia
Girolomoni, G:
Univ Verona, Sect Dermatol & Venereol, Dept Med, Verona, Italy
Hercogova, J:
Charles Univ Prague, Med Fac 2, Dermatol Dept, Prague, Czech Republic
Na Bulovce Hosp, Dermatol Dept, Prague, Czech Republic
Hong, C:
Univ British Columbia, Dept Dermatol & Skin Sci, Vancouver, BC, Canada
Katoh, N:
Kyoto Prefectural Univ Med, Dept Dermatol, Grad Sch Med Sci, Kyoto, Japan
Pink, A:
Guys & St Thomas NHS Fdn Trust, St Johns Inst Dermatol, London, England
Kings Coll London, Dept Dermatol, London, England
Richard, M:
Marseille Univ, Res Ctr Hlth Serv & Qual Life, CEReSS EA 3279, Aix En Provence, France
Univ Hosp Timone, Dermatol Dept, Marseille, France
AP HM, Dermatol Dept, Marseille, France
Shumack, S:
Royal North Shore Hosp, Dept Dermatol, Sydney, NSW, Australia
:
Hosp Gen Alicante, Dept Dermatol, Alicante, Spain
Weidinger, S:
Univ Hosp Schleswig Holstein, Dept Dermatol & Allergy, Campus Kiel, Kiel, Germany
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