Chia-Yu Chu, Yung Chan, Siriwan Wananukul, Hao Cheng, Nisha Suyien Chandran, Ramesh Bhat, Sang Wook Son, Han-Fang Liao, Sean Gardiner, Qi Qing Ng, See-Hwee Yeo, Sophie Bozhi Chen, Yoko Kataoka
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引用次数: 0
Abstract
Introduction: Limited evidence is available on real-world management of atopic dermatitis (AD) among Asian adults. This cross-sectional study aimed to assess current approaches in AD diagnosis and management in Asia.
Methods: Practising dermatologists regularly treating patients with moderate-to-severe AD were recruited from eight Asia-Pacific territories, namely Mainland China, Hong Kong, India, Japan, Singapore, South Korea, Taiwan, and Thailand. A survey was administered to eligible dermatologists after screening and taking informed consent. Data from fully completed submissions were analysed using descriptive statistics. The study was reviewed by the institutional review board in each territory.
Results: Data from 271 dermatologists were included for analysis. About one-third (31.7%) reported that they referred to the Hanifin and Rajka criteria during diagnosis. The majority of dermatologists used clinical impression when assessing AD severity and treatment response. Reduction of eczema and pruritus was the primary treatment objective when managing both acute (98.1%) and chronic (69.1%) AD. More than half of dermatologists preferred adding systemic anti-inflammatory medication for patients who did not respond to maximized topical treatment, while 43.6% would switch to another systemic medication for those failing to respond to maximized systemic treatment. Topical corticosteroids were frequently selected by dermatologists. For systemic therapies, oral corticosteroids were most frequently used, followed by cyclosporin and dupilumab. Narrow-band ultraviolet B was the most common phototherapy reported (84.9%). There was considerable variation in estimated average and maximum durations of therapies used to treat AD.
Conclusion: This study has provided insights on the real-world management of moderate-to-severe AD in the Asia-Pacific region. The diverse approaches in diagnosis and treatment highlight the multifactorial nature of AD, reliance on clinical judgement, and importance of personalized care. To improve outcomes in patients with AD, it will be crucial to develop biomarkers for diagnosis, reduce subjectivity in assessment, as well as promote access to newer and effective therapies.
导言：有关亚洲成年人特应性皮炎（AD）实际治疗情况的证据有限。这项横断面研究旨在评估目前亚洲特应性皮炎的诊断和治疗方法：方法：从亚太地区的八个国家（中国大陆、香港、印度、日本、新加坡、韩国、台湾和泰国）招募了定期治疗中重度特应性皮炎患者的皮肤科医生。经过筛选并征得知情同意后，对符合条件的皮肤科医生进行了问卷调查。我们使用描述性统计方法对完整填写的问卷数据进行了分析。该研究已通过各地区机构审查委员会的审查：共有 271 名皮肤科医生的数据被纳入分析范围。约有三分之一（31.7%）的皮肤科医生表示，他们在诊断时参考了哈尼芬和拉杰卡标准。大多数皮肤科医生在评估 AD 的严重程度和治疗反应时使用的是临床印象。在治疗急性（98.1%）和慢性（69.1%）AD 时，减少湿疹和瘙痒是首要治疗目标。半数以上的皮肤科医生倾向于在局部治疗无效的患者中添加全身抗炎药物，43.6%的皮肤科医生会在全身治疗无效的患者中改用另一种全身药物。皮肤科医生经常选择外用皮质类固醇激素。在全身治疗方面，最常用的是口服皮质类固醇激素，其次是环孢素和杜比单抗。窄带紫外线 B 是最常见的光疗方法（84.9%）。用于治疗AD的疗法的估计平均持续时间和最长持续时间存在很大差异：这项研究为亚太地区中重度白内障患者的实际治疗提供了见解。诊断和治疗方法的多样性凸显了注意力缺失症的多因素性质、对临床判断的依赖以及个性化护理的重要性。为了改善注意力缺失症患者的治疗效果，开发诊断生物标志物、减少评估中的主观性以及促进更新、更有效疗法的使用将至关重要。
期刊介绍：
Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged.
Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers.
The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.
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