Treat-to-target in dermatology: A scoping review and International Eczema Council survey on the approach in atopic dermatitis

Yael Renert-Yuval*, Ester Del Duca, Bernd Arents, Robert Bissonnette, Aaron M. Drucker, Carsten Flohr, Emma Guttman-Yassky, Dirkjan Hijnen, Kenji Kabashima, Yael A. Leshem, Amy S. Paller, Jonathan I. Silverberg, Eric L. Simpson, Phyllis Spuls, Christian Vestergaard, Andreas Wollenberg, Alan D. Irvine, Jacob P. Thyssen

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Treat-to-target (T2T) is a pragmatic therapeutic strategy being gradually introduced into dermatology after adoption in several other clinical areas. Atopic dermatitis (AD), one of the most common inflammatory skin diseases, may also benefit from this structured and practical therapeutic approach. We aimed to evaluate existing data regarding the T2T approach in dermatology, with a specific focus on AD, as well as the views of International Eczema Council (IEC) members on the potential application of a T2T approach to AD management. To do so, we systematically searched for peer-reviewed publications on the T2T approach for any skin disease in the PubMed and Scopus databases up to February 2022 and conducted a survey among IEC members regarding various components to potentially include in a T2T approach in AD. We identified 21 relevant T2T-related reports in dermatology, of which 14 were related to psoriasis, five to AD, one for juvenile dermatomyositis and one for urticaria. In the IEC member survey, respondents proposed treatable traits (with itch, disease severity and sleep problems getting the highest scores), relevant comorbidities (with asthma being selected most commonly, followed by anxiety and depression in adults), recommended specialists that should define the approach in AD (dermatologists, allergists and primary care physicians were most commonly selected in adults), and applicable assessment tools (both physician- and patient-reported), in both adult and paediatric patients, for potential future utilization of the T2T approach in AD. In conclusion, while the T2T approach may become a useful tool to simplify therapeutic goals and AD management, its foundation in AD is only starting to build. A multidisciplinary approach, including a wide range of stakeholders, including patients, is needed to further define the essential components needed to utilize T2T in AD.

Original languageEnglish (US)
Pages (from-to)42-51
Number of pages10
JournalJournal of the European Academy of Dermatology and Venereology
Volume38
Issue number1
DOIs
StatePublished - Jan 2024

ASJC Scopus subject areas

  • Infectious Diseases
  • Dermatology

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