{"title":"临床实践中的治疗目标：根据特应性皮炎共识指南评估现实世界的成功率。","authors":"Zhao Wang, Luyue Zhang, Ruitao Fan, Jing Shi, Miao Qin, Shijiao Xu, Songmei Geng","doi":"10.1007/s13555-025-01508-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Treat-to-target (T2T) strategies have been adopted in atopic dermatitis (AD) management, which defines specific moderate/acceptable and optimal targets for reducing disease severity. However, real-world evidence on the achievement rates of these targets remains limited.</p><p><strong>Methods: </strong>This prospective observational study enrolled patients with moderate-to-severe AD without treatment protocol modifications. Disease severity was longitudinally assessed using 5-point Patient Global Impression of Severity (PGIS-5), Peak Pruritus Numerical Rating Scale (pp-NRS), Dermatology Life Quality Index (DLQI), Patient-Oriented Eczema Measure (POEM), Body Surface Area (BSA), Eczema Area and Severity Index (EASI), and Scoring Atopic Dermatitis (SCORAD) at baseline and weeks 2, 4, 8, and 16. Treatment responses were compared against two established T2T frameworks: the T2T consensus (de Bruin-Weller et al.) and Aiming High in Eczema/Atopic Dermatitis (AHEAD) recommendations (Silverberg et al.). Target feasibility was evaluated through achievement rates, with thresholds calibrated to balance timely clinical response.</p><p><strong>Results: </strong>Sixty-one patients with moderate-to-severe AD were enrolled. All outcomes measured showed significant improvement over the 16-week observation period. SCORAD50, EASI50, pp-NRS reduction ≥ 3/4, and DLQI reduction ≥ 4 demonstrated appropriate moderate target feasibility. SCORAD75, EASI75/90, pp-NRS ≤ 1, BSA ≤ 2%, and DLQI 0/1 were suitable as optimal targets. Percentage improvements of EASI and SCORAD were more reliable than absolute values. Current targets for PGIS-5 (reduction ≥ 1), POEM (reduction ≥ 4), and BSA (50% improvement) in the moderate category and PGIS-5 ≤ 2 and POEM ≤ 7 in the optimal category may require stricter criteria.</p><p><strong>Conclusion: </strong>Our finding reflects the real-world achievement rate of the current T2T consensus, suggesting that higher thresholds may be warranted in future refinements of T2T strategies.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"2897-2910"},"PeriodicalIF":4.2000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454827/pdf/","citationCount":"0","resultStr":"{\"title\":\"Treat-to-Target in Clinical Practice: Evaluating Real-World Achievement Rates Against Consensus Guidelines for Atopic Dermatitis.\",\"authors\":\"Zhao Wang, Luyue Zhang, Ruitao Fan, Jing Shi, Miao Qin, Shijiao Xu, Songmei Geng\",\"doi\":\"10.1007/s13555-025-01508-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Treat-to-target (T2T) strategies have been adopted in atopic dermatitis (AD) management, which defines specific moderate/acceptable and optimal targets for reducing disease severity. However, real-world evidence on the achievement rates of these targets remains limited.</p><p><strong>Methods: </strong>This prospective observational study enrolled patients with moderate-to-severe AD without treatment protocol modifications. Disease severity was longitudinally assessed using 5-point Patient Global Impression of Severity (PGIS-5), Peak Pruritus Numerical Rating Scale (pp-NRS), Dermatology Life Quality Index (DLQI), Patient-Oriented Eczema Measure (POEM), Body Surface Area (BSA), Eczema Area and Severity Index (EASI), and Scoring Atopic Dermatitis (SCORAD) at baseline and weeks 2, 4, 8, and 16. Treatment responses were compared against two established T2T frameworks: the T2T consensus (de Bruin-Weller et al.) and Aiming High in Eczema/Atopic Dermatitis (AHEAD) recommendations (Silverberg et al.). Target feasibility was evaluated through achievement rates, with thresholds calibrated to balance timely clinical response.</p><p><strong>Results: </strong>Sixty-one patients with moderate-to-severe AD were enrolled. All outcomes measured showed significant improvement over the 16-week observation period. SCORAD50, EASI50, pp-NRS reduction ≥ 3/4, and DLQI reduction ≥ 4 demonstrated appropriate moderate target feasibility. SCORAD75, EASI75/90, pp-NRS ≤ 1, BSA ≤ 2%, and DLQI 0/1 were suitable as optimal targets. Percentage improvements of EASI and SCORAD were more reliable than absolute values. Current targets for PGIS-5 (reduction ≥ 1), POEM (reduction ≥ 4), and BSA (50% improvement) in the moderate category and PGIS-5 ≤ 2 and POEM ≤ 7 in the optimal category may require stricter criteria.</p><p><strong>Conclusion: </strong>Our finding reflects the real-world achievement rate of the current T2T consensus, suggesting that higher thresholds may be warranted in future refinements of T2T strategies.</p>\",\"PeriodicalId\":11186,\"journal\":{\"name\":\"Dermatology and Therapy\",\"volume\":\" \",\"pages\":\"2897-2910\"},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454827/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Dermatology and Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s13555-025-01508-w\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/5 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"DERMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Dermatology and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13555-025-01508-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/5 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"DERMATOLOGY","Score":null,"Total":0}
Treat-to-Target in Clinical Practice: Evaluating Real-World Achievement Rates Against Consensus Guidelines for Atopic Dermatitis.
Introduction: Treat-to-target (T2T) strategies have been adopted in atopic dermatitis (AD) management, which defines specific moderate/acceptable and optimal targets for reducing disease severity. However, real-world evidence on the achievement rates of these targets remains limited.
Methods: This prospective observational study enrolled patients with moderate-to-severe AD without treatment protocol modifications. Disease severity was longitudinally assessed using 5-point Patient Global Impression of Severity (PGIS-5), Peak Pruritus Numerical Rating Scale (pp-NRS), Dermatology Life Quality Index (DLQI), Patient-Oriented Eczema Measure (POEM), Body Surface Area (BSA), Eczema Area and Severity Index (EASI), and Scoring Atopic Dermatitis (SCORAD) at baseline and weeks 2, 4, 8, and 16. Treatment responses were compared against two established T2T frameworks: the T2T consensus (de Bruin-Weller et al.) and Aiming High in Eczema/Atopic Dermatitis (AHEAD) recommendations (Silverberg et al.). Target feasibility was evaluated through achievement rates, with thresholds calibrated to balance timely clinical response.
Results: Sixty-one patients with moderate-to-severe AD were enrolled. All outcomes measured showed significant improvement over the 16-week observation period. SCORAD50, EASI50, pp-NRS reduction ≥ 3/4, and DLQI reduction ≥ 4 demonstrated appropriate moderate target feasibility. SCORAD75, EASI75/90, pp-NRS ≤ 1, BSA ≤ 2%, and DLQI 0/1 were suitable as optimal targets. Percentage improvements of EASI and SCORAD were more reliable than absolute values. Current targets for PGIS-5 (reduction ≥ 1), POEM (reduction ≥ 4), and BSA (50% improvement) in the moderate category and PGIS-5 ≤ 2 and POEM ≤ 7 in the optimal category may require stricter criteria.
Conclusion: Our finding reflects the real-world achievement rate of the current T2T consensus, suggesting that higher thresholds may be warranted in future refinements of T2T strategies.
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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