Strategies used for measuring long-term control in atopic dermatitis trials: A systematic review

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:75

Review

Barbarot, Sebastien^1,2  Rogers, Natasha K.¹  Abuabara, Katrina³  Aubert, Helene²  Chalmers, Joanne¹  Flohr, Carsten^4,5  Hanifin, Jon⁶  Naldi, Luigi^7,8  Margolis, David J.^9,10  Paul, Carle^11,12  Ridd, Matthew J.¹³  Schuttelaar, Marie-Louise Anna¹⁴  Simpson, Eric⁶  Tauber, Marie^11,12  Volke, Annika¹⁵  Weidinger, Stephan¹⁶  Wilkes, Sally R.¹  Wollenberg, Andreas¹⁷  Thomas, Kim S.¹ 

[1] Univ Nottingham, Ctr Evidence Based Dermatol, Nottingham NG7 2RD, England

[2] CHU Nantes, Dept Dermatol, Nantes, France

[3] Univ Calif San Francisco, Dept Dermatol, San Francisco, CA 94143 USA

[4] Guys & St Thomas Natl Hlth Serv Fdn Trust, St Johns Inst Dermatol, Populat Based Dermatol Res Unit, London, England

[5] Kings Coll London, London WC2R 2LS, England

[6] Oregon Hlth & Sci Univ, Dept Dermatol, Portland, OR 97201 USA

[7] Azienda Osped Papa Giovanni XXIII, Study Ctr Italian Grp Epidemiol Res Dermatol, Bergamo, Italy

[8] Azienda Osped Papa Giovanni XXIII, Dept Dermatol, Bergamo, Italy

[9] Univ Penn, Perelman Sch Med, Dept Dermatol, Philadelphia, PA 19104 USA

[10] Univ Penn, Perelman Sch Med, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA

[11] Paul Sabatier Univ, Dermatol, Toulouse, France

[12] Hop Larrey, Toulouse, France

[13] Univ Bristol, Sch Social & Community Med, Bristol BS8 1TH, Avon, England

[14] Univ Groningen, Univ Med Ctr Groningen, Dept Dermatol, NL-9700 AB Groningen, Netherlands

[15] Univ Tartu, Dept Dermatol, Tartu, Estonia

[16] Univ Hosp Schleswig Holstein, Dept Dermatol Venereol & Allergy, Campus Kiel, Kiel, Germany

[17] Ludwig Maximilian Univ Munich, Dept Dermatol & Allergy, Munich, Germany

关键词: atopic dermatitis;    atopic eczema;    flares;    long-term control;    outcome measures;    randomized controlled trials;    systematic review;   

DOI  :  10.1016/j.jaad.2016.05.043

来源: Elsevier

【 摘 要 】

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.

【 授权许可】

Free