Journal
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
Volume 75, Issue 5, Pages 1038-1044Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jaad.2016.05.043
Keywords
atopic dermatitis; atopic eczema; flares; long-term control; outcome measures; randomized controlled trials; systematic review
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Funding
- National Institute for Health Research (NIHR) [PDF-2014-07-013]
- National Institute for Health Research [CTF-01-12-06, PDF-2014-07-013] Funding Source: researchfish
- National Institutes of Health Research (NIHR) [CTF-01-12-06, PDF-2014-07-013] Funding Source: National Institutes of Health Research (NIHR)
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Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease. There are no standardized methods for capturing long-term control of AD. Objective: We sought to identify how long-term control has been captured in published randomized controlled trials (RCTs). Results will initiate consensus discussions on how best to measure long-term control in the core outcome set for AD. Methods: We conducted a systematic review of RCTs of AD treatments published between 2000 and 2013, with a follow-up period of 3 months or longer, at least 1 outcome measure recorded at 3 or more time points, full article available, and published in English. Results: In all, 101 of 353 RCTs were eligible. Methods to capture long-term control included: repeated measurement of AD outcomes (92 RCTs; 91%), use of AD medication (29 RCTs; 28.7%), and AD flares/remissions (26 RCTs; 25.7%). Repeated measurements of AD outcomes were typically collected 3 to 5 times during a trial, but analysis methods often failed to make best use of the data. Time to first flare was most commonly used for trials includingflaredata (21/52). Medicationuse was recorded based on quantity, potency, and frequency of application. Limitations: We included RCT data only. Conclusion: This review illustrates the difficulties in measuring long-term control, and points to the need for improved harmonization of outcomes.
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