Challenges in the use of the treat-to-treat strategy in atopic dermatitis in Latin America: A case series review

ABSTRACT: Introduction: Atopic dermatitis (AD) is a chronic, relapsing-remitting illness. In moderate-to-severe instances, recommendations urge patient-centered systemic therapy. Existing standards lack long-term treatment success requirements. A treat-to-target methodology was proposed for systemic...

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Autores:
Chérrez Ojeda, Manuel Iván
Robles Velasco, Karla
Francis Thomsen, Simon
Ramon, German Dario
Sánchez Caraballo, Jorge Mario
Bernstein, Jonathan A.
Hidalgo Matlock, Benjamín
Tipo de recurso:
Article of investigation
Fecha de publicación:
2023
Institución:
Universidad de Antioquia
Repositorio:
Repositorio UdeA
Idioma:
eng
OAI Identifier:
oai:bibliotecadigital.udea.edu.co:10495/45164
Acceso en línea:
https://hdl.handle.net/10495/45164
Palabra clave:
Medición de Resultados Informados por el Paciente
Patient Reported Outcome Measures
Dermatitis Atópica
Dermatitis, Atopic
Enfermedades Cutáneas Genéticas
Skin Diseases, Genetic
Resultado del Tratamiento
Treatment Outcome
https://id.nlm.nih.gov/mesh/D000071066
https://id.nlm.nih.gov/mesh/D003876
https://id.nlm.nih.gov/mesh/D012873
https://id.nlm.nih.gov/mesh/D016896
Rights
openAccess
License
http://creativecommons.org/licenses/by-nc/2.5/co/
Description
Summary:ABSTRACT: Introduction: Atopic dermatitis (AD) is a chronic, relapsing-remitting illness. In moderate-to-severe instances, recommendations urge patient-centered systemic therapy. Existing standards lack long-term treatment success requirements. A treat-to-target methodology was proposed for systemic therapy patients that requires global improvements to prompt decisions about treatment. Methods: We conducted an observational study between May 2021 and June 2022 in three Ecuadorian patients with severe AD who were treated with dupilumab to assess the clinical evolution and behavior of the subdomains evaluated by clinimetric tools. Results: Patients A and C satisfied disease-domain response criteria to dupilumab at 12 and 24 weeks, but B did not complete the algorithm objectives. Nonetheless, patient A improved AD severity, itching, bleeding, desquamation, sleep, daily activities, mood, emotions, sexual troubles, clothing, and sports subdomains. Patient B experienced reduced symptomatology, AD aggravation, daily activities impact, and work/study impairment. Patient C improved from severe to mild desquamation, itching, exudate, lichenification, and rough/dry skin. Sleep, shame, and study subdomains improved the most. Conclusion: We provide a new operational construct for analyzing current patient-reported outcome measures (PROMs) and clinician-reported outcome measures (CROMs) based on subdomains to widen our understanding of the state of disease activity and make clinical decisions when the treat-to-target strategy is not attained.