Agache Ioana, Akdis Cezmi A, Akdis Mubeccel, Brockow Knut, Chivato Tomas, Del Giacco Stefano, Eiwegger Thomas, Eyerich Kilian, Giménez-Arnau Ana, Gutermuth Jan, Guttman-Yassky Emma, Maurer Marcus, Ogg Graham, Ong Peck Y, O'Mahony Liam, Schwarze Jürgen, Warner Amena, Werfel Thomas, Palomares Oscar, Jutel Marek
Faculty of Medicine, Transylvania University, Brasov, Romania.
Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.
Allergy. 2021 Apr;76(4):988-1009. doi: 10.1111/all.14690. Epub 2020 Dec 27.
Atopic dermatitis imposes a significant burden on patients, families and healthcare systems. Management is difficult, due to disease heterogeneity, co-morbidities, complexity in care pathways and differences between national or regional healthcare systems. Better understanding of the mechanisms has enabled a stratified approach to the management of atopic dermatitis, supporting the use of targeted treatments with biologicals. However, there are still many issues that require further clarification. These include the definition of response, strategies to enhance the responder rate, the duration of treatment and its regimen (in the clinic or home-based), its cost-effectiveness and long-term safety. The EAACI Guidelines on the use of dupilumab in atopic dermatitis follow the GRADE approach in formulating recommendations for each outcome and age group. In addition, future approaches and research priorities are discussed.
特应性皮炎给患者、家庭和医疗保健系统带来了沉重负担。由于疾病的异质性、合并症、护理途径的复杂性以及国家或地区医疗保健系统之间的差异，管理起来很困难。对发病机制的更好理解使得采用分层方法管理特应性皮炎成为可能，这支持了使用生物制剂进行靶向治疗。然而，仍有许多问题需要进一步阐明。这些问题包括缓解的定义、提高缓解率的策略、治疗持续时间及其方案（在诊所或居家治疗）、成本效益和长期安全性。欧洲变态反应和临床免疫学会（EAACI）关于度普利尤单抗治疗特应性皮炎的指南在为每个结局和年龄组制定建议时遵循了GRADE方法。此外，还讨论了未来的方法和研究重点。
