Canadian Consensus Guidelines for the Management of Atopic Dermatitis with Topical Therapies.

IF 3.5 3区 医学 Q1 DERMATOLOGY
Dermatology and Therapy Pub Date : 2025-06-01 Epub Date: 2025-04-25 DOI:10.1007/s13555-025-01386-2
Melinda J Gooderham, H Chih-Ho Hong, Charles Lynde, Kim A Papp, Jensen Yeung, Harvey Lui, Yvette Miller-Monthrope, Julien Ringuet, Irina Turchin, Vimal H Prajapati
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引用次数: 0

Abstract

Introduction: Atopic dermatitis (AD) is a highly prevalent disease in Canada with significant patient burden. Treatment guidance for topical therapy (the mainstay of AD management), with particular consideration of emerging treatments, may further improve patient care. Here, we aim to provide healthcare professionals with AD treatment recommendations from the perspective of 10 Canadian dermatologists with expertise in managing AD.

Methods: The panel of dermatologists conducted a systematic literature review and leveraged their clinical experience to develop generally accepted principles, consensus statements, and a treatment algorithm using an iterative consensus process.

Results: The panel collectively developed six generally accepted principles, 10 consensus statements, and a treatment algorithm. The guidance notes that assessment of disease severity should encompass both physician-rated measures and patient-reported outcomes. Disease education, lifestyle-based strategies (e.g., trigger avoidance), and supportive measures (e.g., moisturizers) can help reduce signs and symptoms of AD. Choice of therapy should consider disease-, patient-, and treatment-related factors. Although topical corticosteroids (TCS) are often used as first-line treatment in AD, they should be limited to intermittent short-term use. Noncorticosteroid topical therapies (e.g., topical calcineurin inhibitors; topical phosphodiesterase-4 inhibitors; and topical Janus kinase inhibitors) can be used for widespread involvement of AD according to approved use. Once treatment goals are achieved, noncorticosteroid topical maintenance therapy should continue to prevent flares and reduce the need for TCS.

Conclusion: Guidance reflecting the benefits and limitations of topical AD treatments in conjunction with patient understanding of treatment goals supports robust shared decision-making in the management of AD.

局部治疗特应性皮炎的加拿大共识指南。
简介:特应性皮炎(AD)在加拿大是一种高度流行的疾病,患者负担显著。局部治疗的治疗指导(AD管理的支柱),特别考虑新兴的治疗方法,可以进一步改善患者的护理。在这里,我们旨在从10位加拿大皮肤科医生的角度为医疗保健专业人员提供AD治疗建议。方法:皮肤科医生小组进行了系统的文献综述,并利用他们的临床经验制定了普遍接受的原则、共识声明和使用迭代共识过程的治疗算法。结果:专家组共同制定了6项普遍接受的原则,10项共识声明和一种治疗算法。该指南指出,疾病严重程度的评估应包括医生评估的措施和患者报告的结果。疾病教育、基于生活方式的策略(例如,避免触发)和支持性措施(例如,保湿剂)可以帮助减少AD的体征和症状。治疗的选择应考虑疾病、患者和治疗相关因素。虽然局部皮质类固醇(TCS)常被用作阿尔茨海默病的一线治疗,但它们应限于间歇性短期使用。非皮质类固醇局部治疗(例如,局部钙调磷酸酶抑制剂;局部磷酸二酯酶-4抑制剂;和局部Janus激酶抑制剂)可以根据批准的用途用于广泛涉及的AD。一旦达到治疗目标,非皮质类固醇局部维持治疗应继续预防耀斑和减少TCS的需要。结论:反映局部AD治疗的益处和局限性的指南,结合患者对治疗目标的理解,支持AD管理中强有力的共同决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Dermatology and Therapy
Dermatology and Therapy Medicine-Dermatology
CiteScore
6.00
自引率
8.80%
发文量
187
审稿时长
6 weeks
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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