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

Sebastien Barbarot, Natasha K. Rogers, Katrina Abuabara, Helene Aubert, Joanne Chalmers, Carsten Flohr, Jon Hanifin, Luigi Naldi, David J. Margolis, Carle Paul, Matthew J. Ridd, Marie-Louise Anna Schuttelaar, Eric Simpson, Marie Tauber, Annika Volke, Stephan Weidinger, Sally R. Wilkes, Andreas Wollenberg, Kim S. Thomas

Research output: Contribution to journalArticle (Academic Journal)peer-review

19 Citations (Scopus)
265 Downloads (Pure)

Abstract

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 including flare data (21/52). Medication use 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.
Original languageEnglish
Pages (from-to)1038-1044
Number of pages7
JournalJournal of the American Academy of Dermatology
Volume75
Issue number5
Early online date10 Aug 2016
DOIs
Publication statusPublished - Nov 2016

Keywords

  • atopic dermatitis
  • atopic eczema
  • flares
  • long-term control
  • outcome measures
  • randomized controlled trials
  • systematic review

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