Evolution of assessment of long-term control of and treat-to-target in atopic dermatitis / 中华皮肤科杂志

Research progress in the establishment of long-term control goals and treat-to-target in the treatment of atopic dermatitis (AD) was searched and summarized in this review. The TREatment of ATopic eczema (TREAT) Registry Taskforce defined a minimum follow-up frequency of initially 4 weeks after commencing treatment, then every 3 months while on treatment and every 6 months while off treatment; the international Harmonising Outcome Measures for Eczema (HOME) group recommended that the long-term control of AD should be measured by either the Recap of Atopic Eczema (RECAP) instrument or the Atopic Dermatitis Control Tool (ADCT) . In order to achieve the treat-to-target in AD, a panel comprising 87 participants from 28 countries developed and published "Treat-to-target in atopic dermatitis: an international consensus on a set of core decision points for systemic therapies" in early 2021, which recommended 3 months and 6 months as two evaluation time points, and various disease outcome domains spanning symptoms, signs, quality of life plus patient global assessment as the target. By setting the time-specific outcome thresholds, the consensus provided a framework for shared decision-making on systemic treatment adjustment for AD patients. This review summarizes concepts and indicators related to the assessment of long-term control of and treat-to-target in AD, in the hope of providing some ideas for clinical management, especially the long-term control, of AD in China.

Pharmacologic Therapy of Asthma in Childhood

Asthma is one of the most common allergic diseases in children. As a result of the advances in immunology and the studies of BAL and lung biopsy, the definition of asthma has been changed as a 'chronic inflammatory disorder of the airways'. Therefore pharmacologic therapy of asthma is focused on the control of allergic inflammation. According to its purpose, the asthma medication could be classified into two groups, that is, quick-relief agents and long-term control agents. Quick-relief agents give a prompt relief of acute symptoms (coughing, wheezing, difficulty of breathing, and chest tightness) and prevent exercise-induced bronchospasm. Short-acting inhaled β2-agonist is at present the most effective quick-relief agent. Long-term control agents are taken daily and chronically (for a long period of time) to maintain the control of persistent asthma and to prevent exacerbations, and include inhaled corticosteroid, cromolyn sodium, and others. A stepwise approach is recommended for treating a child with asthma to attain and maintain asthma control. Medications should be carefully chosen according to the severity of asthma and age of children.