Consensus on the clinical approach to moderate-to-severe atopic dermatitis in Spain: A Delphi survey
Entity
Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD); UAM. Departamento de MedicinaPublisher
Hindawi Ltd.Date
2020-04-07Citation
10.1155/2020/1524293
Dermatology Research and Practice 2020 (2020): 1524293
ISSN
1687-6105 (print); 1687-6113 (online)DOI
10.1155/2020/1524293Editor's Version
http://doi.org/10.1155/2020/1524293Subjects
AD; Delphi; Dermatologists; Allergologists; Spain; Severity of the disease; Treatment; Biomarkers; MedicinaRights
© 2020 Joaquín Sastre et al.Abstract
Background. -e purpose of this study was to gather information on the current assessment and management of patients with
moderate-to-severe AD in routine daily practice. Methods. A cross-sectional two-round Delphi survey with the participation of
dermatologists and allergologists throughout Spain was conducted. -ey completed a 46-item questionnaire, and consensus was
defined when responses of ≥80% of participants coincided in the categories of a 5-point Likert scale for that item. Results. A total of
105 specialists (aged 40–59 years) completed the two rounds. Participants agreed regarding the consideration of AD as a
multifaceted disease and the differences in clinical presentation of AD according to the patient’s age. It is recommendable to
perform a skin biopsy to exclude early stage T-cell cutaneous lymphoma, psoriasis, or dermatitis herpetiformis, among others
(99.1%). Also, consensus was reached regarding the use of the SCORAD index to quantify the severity of the disease (86.7%), the
use of wet wraps to increase the effect of topical corticosteroids (90.4%), the usefulness of proactive treatment during follow-up
(85.6%) and tacrolimus ointment (91.2%) to reduce new flares, and the fact that crisaborole is not the treatment of choice for
severe AD (92.4%). AD was not considered a contraindication for immunotherapy in patients with allergic respiratory diseases
(92.4%). In patients with severe AD, the use of immune response modifier drugs (97.6%) or phototherapy (92.8%) does not
sufficiently cover their treatment needs. Consensus was also obtained regarding the role of the new biologic drugs (93.6%)
targeting cytokines involved in the -2 inflammatory pathway (92.0%) and the potential role of dupilumab as first-line treatment
(90.4%) in moderate-to-severe AD patients. Conclusion. -is study contributes a reference framework to the care of AD patients.
-ere is no diagnostic test or biomarkers to direct treatment or to assess the severity of the disease, and many therapeutic challenges remain
Files in this item
Google Scholar:Sastre Domínguez, Joaquín
-
Serra Baldrich, Esther
-
Armario Hita, José Carlos
-
Herráez, L.
-
Jáuregui, Ignacio
-
Martín-Santiago, Ana
-
Ortiz de Frutos, Javier
-
Siñvestre, Juan Francisco
-
Valero, Antonio
This item appears in the following Collection(s)
Related items
Showing items related by title, author, creator and subject.
-
Population-based multicase-control study in common tumors in Spain (MCC-Spain): Rationale and study design
Castaño-Vinyals, Gemma; Aragonés, Nuria; Pérez-Gómez, Beatriz; Martín, Vicente; Llorca, Javier; Moreno, Víctor; Altzibar, Jone M.; Ardanaz, Eva; De Sanjosé, Sílvia; Jiménez-Moleón, José J.; Tardón, Adonina; Alguacil, Juan; Peiró, Rosana; Marcos-Gragera, Rafael; Navarro, Carmen; Pollán Santamaría, Marina Anunciación; Kogevinas, Manolis; Alonso, Maria Teresa; Amiano, Pilar; Arias, Cristina; Azpiri, Mikel; Benavente, Yolanda; Boldo, Elena; Bueno, Aurora; Bustamante, Mariona; Caballero, Francisco Javier; Campo, Elías; Cantón, Rafael; Capelo, Rocío; Carmona, Carme; Casabonne, Delphine; Chirlaque, María Dolores; Cirac, Judith; Clofent, Juan; Colado, Enrique; Costas, Laura; Crous, Marta; Campo, Rosa del; Díaz Santos, Marian; Dierssen-Sotos, Trinidad; Ederra, María; Espinosa, Ana; Fernández Cabrera, Marieta; Fernández Somoano, Ana; Fernández Villa, Tania; García García-Esquinas, Esther
; García Martín, Paloma; Gómez-Acebo, Inés; Puga, Cristina González; Gràcia, Esther; Eslava, Marcela Guevara; Guinó, Elisabet; Huerta, José María; Lope, Virginia; López-Abente, Gonzalo; López-Otín, Carlos; Martínez Argüelles, Begoña; Merino Salas, Sergio; Mirón Pozo, Benito; Molina dee La Torre, Antonio José; Moreno, Eduardo; Moreno Iribas, Concepción; Olea, Nicolás; Gelis, Gemma Osca; Paré, Laia; Porta, Miquel; Puig, Montse; Rivad del Fresno, Manuel; Robles, Claudia; Rodríguez Suarez, Marta María; Romero, Beatriz; Sáez Castillo, Ana Isabel; Sala Serra, Maria
2015-01-01