Treatment principles of atopic dermatitis

Thestrup‐Pedersen, Kristian

doi:10.1046/j.1468-3083.2002.00349.x

Cited by 25 publications

(9 citation statements)

References 54 publications

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“…Two-thirds of people with the disease have a family history of atopic eczema, asthma or hay fever. The cumulative prevalence of atopic dermatitis varies from 20% in Northern Europe and the USA to 5% in the South-Eastern Mediterranean (Thestrup 2002). Prevalence data for the symptoms of atopic eczema were collected in the global ISAAC study (International Study of Asthma and Allergies in Childhood).…”

Section: Epidemiology and Causesmentioning

confidence: 99%

Dietary exclusions for established atopic eczema

Bath‐Hextall

Delamere

Williams

2008

Cochrane Database of Systematic Reviews

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Section: Epidemiology and Causesmentioning

confidence: 99%

Dietary exclusions for established atopic eczema

Bath‐Hextall

Delamere

Williams

2008

Cochrane Database of Systematic Reviews

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“…Therefore, it was not possible to compare the benefitto-risk ratio ofthe different agents reviewed. Because of potentially SAEs, systemic remedies should be restricted to patients who do not adequately respond to both topical therapies (first-line therapy for AE) and phototherapy (second-line therapy) (10,11,(63)(64)(65)(66).…”

Section: Limitations Of This Reviewmentioning

confidence: 99%

Systemic Treatment of Severe Atopic Eczema: A Systematic Review

Schmitt¹,

Schäkel²,

Schmitt³

et al. 2007

Acta Derm Venereol

131

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Systemic immunosuppressive agents are recommended for patients with atopic eczema in whom disease activity cannot be controlled adequately with topical treatments. Guidelines do not give clear advice which agents to prefer. We systematically reviewed clinical trials on systemic treatment for severe atopic eczema to provide evidence-based treatment recommendations. Standardized literature search, independent standardized assessment of eligibility and data abstraction was performed by 2 reviewers. Twenty-seven studies totalling 979 patients were included. Eleven studies consistently showed effectiveness of cyclosporine. Cyclosporine is recommended as first option for patients with atopic eczema refractory to conventional treatment. Evidence from randomized controlled trials also exists for interferon-? and azathioprine. Although frequently used in clinical practice, systemic glucocorticosteroids have not been assessed adequately in studies. Mycophenolate mofetile showed effectiveness in 2 small uncontrolled studies. Intravenous immunoglobulins and infliximab are not recommended based on published data.

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“…We searched Medline and the Cochrane central register of controlled trials (both from inception until December 2003) using different combinations of the medical subject (MeSH) terms ‘atopic dermatitis’, ‘randomised controlled trial’, ‘review’, ‘guideline’, ‘consensus’ and text key words including the names of all drugs approved for AE. To identify additional articles with potential information we also reviewed the bibliographies of selected key articles [6, 9,19,20,21]. Finally, we reviewed the summary of product characteristics of all treatment options for moderate-to-severe AE that we intended to include in the treatment algorithm based on our literature search.…”

Section: Methodsmentioning

confidence: 99%

Treatment Following an Evidence-Based Algorithm versus Individualised Symptom-Oriented Treatment for Atopic Eczema

Schmitt¹,

Meurer²,

Schwanebeck³

et al. 2008

Dermatology

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Background: Evidence-based treatment algorithms, successfully established for asthma, are missing for atopic eczema (AE). Objectives: To investigate whether treatment according to an evidence-based algorithm is an effective and applicable concept for the management of AE. Methods: Based on a systematic literature review, we developed an evidence-based severity-score-oriented treatment algorithm for AE and compared its effectiveness to that of an individualised symptom-oriented treatment (individual therapy) in a randomised controlled trial. Sixty-three participants were randomised to algorithm (n = 32) or individual therapy (n = 31) and treated accordingly for 12 months. Study end points included difference between baseline SCORAD and mean SCORAD under treatment (primary end point), quality of life and treatment utilisation. Analysis was by intention to treat (registration: ClinicalTrials.gov:NCT00148746). Results: No statistically significant differences in clinical or subjective response were observed between groups. Treatment following the algorithm and individual treatment both effectively controlled AE. Mean SCORAD reductions were 47% (95% confidence interval, CI = 38–55; algorithm) and 42% (95% CI = 29–54; individual). Clinical response was paralleled by improved quality of life in both groups. Physicians adhered to the algorithm option in 93% of their treatment decisions. Conclusion: Treatment following an evidence-based algorithm is an effective and applicable concept for the management of AE but does not show clear advantages compared to individualised treatment in a dermatological setting.

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Treatment principles of atopic dermatitis

Cited by 25 publications

References 54 publications

Dietary exclusions for established atopic eczema

Dietary exclusions for established atopic eczema

Systemic Treatment of Severe Atopic Eczema: A Systematic Review

Treatment Following an Evidence-Based Algorithm versus Individualised Symptom-Oriented Treatment for Atopic Eczema

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