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Consensus Update for Systemic Treatment of Atopic Dermatitis.

Authors :: Lee JH
Kim JE
Park GH
Bae JM
Byun JY
Shin MK
Han TY
Hong SP
Jang YH
Kim HO
Na CH
Lew BL
Ahn J
Park CO
Seo YJ
Lee YW
Son SW
Choi EH
Park YL
Roh JY
Source :: Annals of dermatology [Ann Dermatol] 2021 Dec; Vol. 33 (6), pp. 497-514. Date of Electronic Publication: 2021 Nov 04.
Publication Year :: 2021
Abstract: Background: In 2015, the Korean Atopic Dermatitis Association (KADA) working group published consensus guidelines for treating atopic dermatitis (AD). Objective: We aimed to provide updated consensus recommendations for systemic treatment of AD in South Korea based on recent evidence and experience. Methods: We compiled a database of references from relevant systematic reviews and guidelines on the systemic management of AD. Evidence for each statement was graded and classified based on thestrength of the recommendation. Forty-two council members from the KADA participated in three rounds of voting to establish a consensus on expert recommendations. Results: We do not recommend long-term treatment with systemic steroids forpatients with moderate-to-severe AD due to the risk of adverse effects. We recommend treatment with cyclosporine or dupilumab and selective treatment with methotrexate or azathioprine for patients with moderate-to-severe AD. We suggest treatment with antihistamines as an option for alleviating clinical symptoms of AD. We recommend selective treatment with narrowband ultraviolet B for patients with chronic moderate-to-severe AD. We do not recommend treatment with oral antibiotics for patients with moderate-to-severe AD but who have no signs of infection. We did not reach a consensus on recommendations for treatment with allergen-specific immunotherapy, probiotics, evening primrose oil, orvitamin D for patients with moderate-to-severe AD. We also recommend educational interventions and counselling for patients with AD and caregivers to improve the treatment success rate. Conclusion: We look forward to implementing a new and updated consensus of systemic therapy in controlling patients with moderate-to-severe AD. Competing Interests: CONFLICTS OF INTEREST: Joo Young Roh is a clinical investigator for Novartis, Bristol-Myers Squibb, Sanofi-Aventis, AbbVie, Boehringer Ingelheim, and Regeneron. (Copyright © 2021 The Korean Dermatological Association and The Korean Society for Investigative Dermatology.)