Treat-to-target in dermatology: A scoping review and International Eczema Council survey on the approach in atopic dermatitis

Yael Renert-Yuval, Laboratory for Investigative Dermatology, The Rockefeller University, New York, New York, USA.
Ester Del Duca, Department of Dermatology, University Magna Graecia, Catanzaro, Italy.
Bernd Arents, Dutch Association for People with Atopic Eczema, Nijkerk, The Netherlands.
Robert Bissonnette, Innovaderm Research, Montreal, Quebec, Canada.
Aaron M. Drucker, Division of Dermatology, Department of Medicine, University of Toronto and Women's College Hospital, Toronto, Ontario, Canada.
Carsten Flohr, St John's Institute of Dermatology, King's College London and Guy's & St Thomas' NHS Foundation Trust, London, UK.
Emma Guttman-Yassky, Department of Dermatology, and Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Dirkjan Hijnen, Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Kenji Kabashima, Department of Dermatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Yael A. Leshem, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Amy S. Paller, Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Jonathan I. Silverberg, Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Eric L. Simpson, Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA.
Phyllis Spuls, Department of Dermatology, Amsterdam Public Health/Infection and Immunology, Amsterdam University Medical Center, Location AMC, University of Amsterdam, Amsterdam, The Netherlands.
Christian Vestergaard, Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.
Andreas Wollenberg, Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany.
Alan D. Irvine, Clinical Medicine, Trinity College Dublin, Dublin, Ireland.
Jacob P. Thyssen, Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.

Document Type

Journal Article

Publication Date

9-12-2023

Journal

Journal of the European Academy of Dermatology and Venereology : JEADV

DOI

10.1111/jdv.19506

Abstract

Treat-to-target (T2T) is a pragmatic therapeutic strategy being gradually introduced into dermatology after adoption in several other clinical areas. Atopic dermatitis (AD), one of the most common inflammatory skin diseases, may also benefit from this structured and practical therapeutic approach. We aimed to evaluate existing data regarding the T2T approach in dermatology, with a specific focus on AD, as well as the views of International Eczema Council (IEC) members on the potential application of a T2T approach to AD management. To do so, we systematically searched for peer-reviewed publications on the T2T approach for any skin disease in the PubMed and Scopus databases up to February 2022 and conducted a survey among IEC members regarding various components to potentially include in a T2T approach in AD. We identified 21 relevant T2T-related reports in dermatology, of which 14 were related to psoriasis, five to AD, one for juvenile dermatomyositis and one for urticaria. In the IEC member survey, respondents proposed treatable traits (with itch, disease severity and sleep problems getting the highest scores), relevant comorbidities (with asthma being selected most commonly, followed by anxiety and depression in adults), recommended specialists that should define the approach in AD (dermatologists, allergists and primary care physicians were most commonly selected in adults), and applicable assessment tools (both physician- and patient-reported), in both adult and paediatric patients, for potential future utilization of the T2T approach in AD. In conclusion, while the T2T approach may become a useful tool to simplify therapeutic goals and AD management, its foundation in AD is only starting to build. A multidisciplinary approach, including a wide range of stakeholders, including patients, is needed to further define the essential components needed to utilize T2T in AD.

Department

Dermatology

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