特应性皮炎长期控制的评估演变与达标治疗

Evolution of assessment of long-term control of and treat-to-target in atopic dermatitis

本文检索并总结特应性皮炎(AD)长期控制的评价指标及治疗目标的研究进展,其中,特应性湿疹治疗工作组将最低随访时间定为开始治疗后最初4周、治疗期间每3个月以及停止治疗后每6个月;湿疹结局测量一致化组织推荐以特应性湿疹概述或AD控制工具作为长期控制效果的评估工具。为实现AD患者的达标治疗,2021年初来自28个国家的87人团队制定并发表了《AD的达标治疗:关于系统治疗的一系列核心决策的国际共识》:以3个月及6个月为评估节点,综合多种疾病指标以及患者总体评分,通过设定达标阈值,进而调整治疗方案。本文总结梳理AD长期控制效果评估及达标治疗相关概念和指标,希望对国内AD的临床治疗,特别是疾病的长期控制有所启发。

Research progress in the establishment of long-term control goals and treat-to-target in the treatment of atopic dermatitis(AD)was searched and summarized in this review.The TREatment of ATopic eczema(TREAT)Registry Taskforce defined a minimum follow-up frequency of initially 4 weeks after commencing treatment,then every 3 months while on treatment and every 6 months while off treatment;the international Harmonising Outcome Measures for Eczema(HOME)group recommended that the long-term control of AD should be measured by either the Recap of Atopic Eczema(RECAP)instrument or the Atopic Dermatitis Control Tool(ADCT).In order to achieve the treat-to-target in AD,a panel comprising 87 participants from 28 countries developed and published“Treat-to-target in atopic dermatitis:an international consensus on a set of core decision points for systemic therapies”in early 2021,which recommended 3 months and 6 months as two evaluation time points,and various disease outcome domains spanning symptoms,signs,quality of life plus patient global assessment as the target.By setting the time-specific outcome thresholds,the consensus provided a framework for shared decision-making on systemic treatment adjustment for AD patients.This review summarizes concepts and indicators related to the assessment of long-term control of and treat-to-target in AD,in the hope of providing some ideas for clinical management,especially the long-term control,of AD in China.