Value of Achieving Minimal Disease Activity in Atopic Dermatitis
Dermatology
The burden of disease and unmet needs in atopic dermatitis
AD is a common, chronic inflammatory skin disease with a significant impact on patients’ lives.1 As a heterogeneous disease, AD has substantial variability in pathogenesis and clinical presentation.
1. Brun S et a l. Immuno. 2022;2:118-31.
2. Van den Bergh PYK et al. J Peripher Nerv Syst. 2021;26(3):242-68.
3. Broers MC et al. Neuroepidemiology. 2019;52(3-4):161-72.
4. Querol LA et al. Neurotherapeutics. 2022;19(3):864-73.
5. Mathey EK et al. J Neurol Neurosurg Psychiatry. 2015;86(9):973-85.
6. Allen JA. Neurol Ther. 2020;9(1):43-54.
7. Cox ZC, Gwathmey KG. Clin Geriatr Med. 2021;37(2):327-45.
8. Dyck PJB, Tracy JA. Mayo Clin Proc. 2018;93(6):777-93.
9. Kuwabara S et al. J Neurol Neurosurg Psychiatry. 2006;77(1):66-70.
10. Gable KL et al. Muscle Nerve. 2020;62:673-80.
11. Allen JA et al. Adv Ther. 2021;38(1):316-28.
12. Mahdi-Rogers M, Hughes RAC. Eur J Neurol. 2014;21(1):28-33.
13. Hafsteinsdottir B, Olafsson E. Eur Neurol. 2016:75(5-6):263-8.
14. Bunschoten C et al. J Peripher Nerv Syst. 2019;24(3):253-9.
15. Divino V et al. PLoS One. 2018;13(10):e0206205.
16. Mendoza M et al. Adv Ther. 2023;40(12):5188-203.
17. Roberts A et al. Neurol Ther. 2025;14(3):1039-59.
References
CIDP: chronic inflammatory demyelinating polyneuropathy; ER: emergency room; Ig: immunoglobulin; IV: intravenous.
Abbreviations
References
The publication of this article was sponsored by AbbVie.
Gkini noted that AD reflects “a systemic condition rather than a skin condition”
Gkini further noted that
pruritus can be really debilitating. Patients are itchy, scratching, which can affect all aspects of their daily life and mental and general well-being. They are not able to sleep, they are not able to go to work, they are not able to go to school, they are not able to function.
Binamer explained:
Some of our patients with very frequent flares have work absences, for example, every 2 weeks, as they are spending time travelling to appointments, refilling prescriptions, going to the emergency room, and completing many assessments.
Therefore, if patients are sub-optimally controlled, even those treated with systemic therapy can continue experiencing significant challenges to their quality of life.4,5 Given the broad impact of AD, patients favour using a combination of patient-reported and clinician-reported outcomes to reflect the total burden of their disease.5
AD management should be individualised, incorporating patient needs in a shared decision-making approach.
The AHEAD consensus-based recommendations outline a novel approach to AD management that combines shared decision making with a treat-to-target approach.6
THE AIMING HIGH IN ECZEMA/ATOPIC DERMATITIS APPROACH: AIMING FOR MINIMAL DISEASE ACTIVITY
Prior to the establishment of the AHEAD recommendations, international experts had identified a lack of evidence on patients’ treatment goals, needs, and expectations in AD management.
As a result, the experts conducted a qualitative patient research survey, which provided robust evidence for the creation of the AHEAD recommendations and supported a patient-centric approach to AD management.1,6
Figure 1: Achievement of minimal disease activity in atopic dermatitis.
The AHEAD recommendations established MDA as a preferred treatment goal in AD. Simultaneous achievement of optimal targets on a PRO and a ClinRO constitutes achievement of MDA (Figure 1 and Table 1).6
≥1 Optimal PRO treatment target achieved
≥1 Optimal ClinRO treatment target achieved
MDA
ClinRO: clinician-reported outcome; MDA: minimal disease activity; PRO: patient-reported outcome.
Created in biorender.com
An increasing number of national guidelines and consensus statements have since adopted MDA as a recommended treatment goal, including those from China, Argentina, Czechia, and the United Arab Emirates.7-10
QUESTION
Achievement of which of the following treatment targets constitutes MDA?
Achievement of EASI 75
Achievement of WP-NRS 0/1 + DLQI 0/1
Achievement of WP-NRS 0/1 + DLQI 0/1
Achievement of EASI 90 + WP-NRS 0/1
Gkini added that STRIVE-AD, a newly published modified Delphi consensus conducted in the UK, serves as a practical recommendations guide on optimising the management of patients with moderate to severe AD. It focuses on five key areas, including a patient-centric approach and aiming for control of the disease with a percentage of patients achieving MDA.11
MDA reflects the burden of AD through the lenses of the patient and the physician, enabling a holistic approach to AD management.6
Gkini emphasised that:
it’s really important to understand what patients experience, how they feel, what their key concerns are, so as to be able to address them.
Patient
Physician
Gkini and Binamer strongly emphasised the importance of shared decision-making with patients. “By discussing which goals they want to achieve, and how we can set up their treatment to achieve them, we try and reach optimal outcomes,” said Binamer.
WHAT DOES ACHIEVING OPTIMAL TREATMENT TARGETS AND MINIMAL DISEASE ACTIVITY MEAN FOR PATIENTS?
Recently published data indicate that achieving MDA is associated with the greatest levels of improvement in health-related quality of life (HRQoL) compared to not achieving MDA.12
In a post-hoc analysis of the Measure Up 1, Measure Up 2, and AD Up Phase III trials, patients randomised to AD treatment or placebo were pooled and stratified into three mutually exclusive response groups meeting optimal, moderate, or neither treatment target for each ClinRO or PRO, and those achieving MDA at Week 16.12
The reported impact on HRQoL was measured across eight domains:
Itch
Sleep
Quality of life
Daily activities
Skin symptoms
Treatment satisfaction
Work productivity
Emotional state
The AHEAD recommendations indicate that the primary treatment goal in AD management should be a satisfied patient with a high quality of life, clear or almost clear skin, and a minimal degree of itching.
Itch
Sleep
Work productivity
Emotional state
In your experience, which of these domains do you believe your patients with AD are most impacted by? (Select more than one)
QUESTION
Quality of life
Daily activities
Treatment satisfaction
Other skin symptoms
Across all measures, a higher proportion of patients who achieved optimal treatment targets were able to attain stringent patient HRQoL outcomes, compared to those meeting moderate or neither treatment target.
In addition, patients who achieved MDA were more likely to attain stringent HRQoL outcomes, versus those who did not achieve MDA. This means that patients who achieved MDA experienced little to no impact of AD on sleep disturbance, daily activities, emotional state, and overall quality of life, among other quality of life measures.12
Itch
Sleep
Quality of life
Work productivity
Emotional state
Daily activities
Skin symptoms
Treatment satisfaction
Specifically, patients who achieved MDA by simultaneously achieving optimal treatment targets of clear or almost clear skin and a minimal degree of itching (i.e., 90% improvement in Eczema Area and Severity Index [EASI-90] and Worst Pruritis Numerical Rating Scale [WP-NRS] 0/1) were:
5X
5X
more likely to experience little to no impact of AD on sleep
more likely to experience little to no impact of AD on daily activities
compared to those who did not achieve this definition of MDA
Furthermore, nearly 73% of these patients were also able to achieve little to no impact on their quality of life (i.e., DLQI 0/1), compared to approximately 4% of patients who did not simultaneously achieve EASI-90 and WP-NRS 0/1 (Figure 2).
Patients who achieve MDA experience worse quality of life outcomes
Patients who achieve MDA experience the greatest levels of improvement across multiple quality of life domains
Patients who achieve MDA only experience improvements in daily activities and work productivity
Which of the following is true regarding patients with AD who achieve MDA, compared to patients who do not achieve MDA?
QUESTION
Regarding these results, Binamer explained:
The difference is clear between a patient who has achieved MDA and one that has not. Achieving MDA means improvement in quality of life, productivity, and psychosocial impact.
[Achieving MDA] can really transform patients’ lives. Why? Before achieving their goals, imagine someone who is constantly itchy and who is not able to sleep.
They are not able to function, they’re not able to study or work. It can affect their relationship with friends, family or partners. It is not only the quality of life. It is the mental health, many patients become depressed, anxious or suicidal because of their condition. Therefore, managing it effectively can be life-transformative.
Gkini highlighted the real-world impact of achieving MDA from the patient perspective:
Binamer added
Many of our patients with AD are young…teenagers or in their early 20s, so they have lots of activities, busy social lives, daily activities… so achieving optimal goals, MDA, such as no more itch, is major for our patients.
Moreover, Binamer reflected on how the achievement of treatment goals, such as MDA, not only impacts patients but also everyone around them.
It does not affect the patient only; it affects their parents, the household, and their work environment. Beyond the numbers and the tests, there is a real-world impact.
Gkini and Binamer also discussed a post-hoc analysis of the real-world MEASURE-AD study, presented at the American Academy of Dermatology (AAD) 2025 Annual Meeting, which examined the association between achieving MDA with flare occurrence and healthcare utilisation in patients with AD.13
WHAT DOES ACHIEVING OPTIMAL TREATMENT TARGETS AND MINIMAL DISEASE ACTIVITY MEAN FOR PHYSICIANS?
Of the 1,434 patients included in the analysis, 20% had received systemic therapy continuously over the past 12 months.
MDA Not Achieved
The number of flares, duration of flares, and number of healthcare visits in the preceding 6 months were assessed in patients who had achieved MDA versus those who had not achieved MDA. A questionnaire was used to assess whether patients thought their AD was being adequately controlled.
Patients who achieved MDA reported fewer flares with shorter duration, compared to those who did not achieve MDA. Patients who achieved MDA also reported fewer AD-related healthcare visits and were more likely to agree that their AD was well controlled.13
Flares
HCRU
80% fewer flares
61% fewer healthcare visits
MDA Not Achieved
MDA Achieved
MDA Achieved
Average number of Flares: 6.9
Average number of flares : 1.4
Average visits: 4.1
Average visits: 1.6
Reflecting from a physician’s perspective, Gkini added: “Generally, in medical dermatology, we want our patients to be well controlled so that there is no need for frequent visits in the clinic.”
See how achieving MDA can impact physicians and patients
Binamer highlighted that a crucial moment in patient management is the first time a patient attends a dermatology clinic.
He recommends that healthcare professionals grasp this opportunity: “Give the patient your time in the first few visits, and this will make subsequent visits shorter as you have taken that time to lay out a management plan.”
HOW DO CLINICIANS IMPLEMENT THE AIMING HIGH IN ECZEMA/ATOPIC DERMATITIS APPROACH AND MINIMAL DISEASE ACTIVITY IN REAL-WORLD CLINICAL PRACTICE
EASI
SCORAD
IGA and BSA
Which measure do you most commonly use to conduct an overall assessment of your patient’s AD?
QUESTION
Binamer recommended a step-by-step approach to management. With the overarching goal of MDA, for example, he suggests beginning with aiming for moderate targets.
If moderate targets are achieved, then he recommends stepping up to optimal targets.
If moderate targets are not achieved within 3–6 months, however, physicians can discuss this outcome with the patient and consider treatment modification or escalation.
Optimal targets
Moderate targets
MDA
Gkini emphasised that:
it’s really important to understand what patients experience, how they feel, what their key concerns are, so as to be able to address them.
It is our responsibility to provide all the relevant information and raise awareness so patients can make informed decisions.
She added that, in the UK, patients are assessed 16 weeks after receiving treatment. If they have fulfilled their goals, patients continue treatment. If they do not, physicians consider treatment optimisation, which can be adding other agents or switching to another treatment, and discuss this with the patient.
Weeks
said Gkini.
This is not a 100-metre sprint, it’s a marathon, and we are running this marathon along with our patients.
WHAT DOES THE FUTURE HOLD FOR PATIENTS WITH ATOPIC DERMATITIS?
Binamer and Gkini reflected on the dramatic evolution that the AD therapeutic landscape has undergone in recent years. Binamer highlighted that only a decade ago, the clinical benchmark for success was a 50% improvement in disease severity.
Today, therapeutic goals have advanced substantially, with targets such as EASI-90 considered realistic in many patients.
With MDA recognised as an attainable and clinically meaningful treatment goal for certain patients, dialogue between patients and physicians around outcomes continues to evolve.
Once limited to discussions of partial symptom control, treatment discussions can now focus on eliminating itch alongside clearing skin and improving HRQoL.
The latest evidence from Silverberg et al.12 emphasises this shift, demonstrating that those achieving MDA experience the greatest improvements in HRQoL across multiple domains. Supported by the growing availability of targeted systemic therapies, MDA is now a realistic outcome for patients with AD. These changes mirror the progress observed in psoriasis management, Binamer remarked.
To conclude, Binamer underscored three key principles for future practice.
Firstly, to avoid “holding treatments hostage,” and recognise the available options for treatment for moderate-to-severe AD.
Secondly, if a patient is unresponsive to topical therapy, act promptly, as timely consideration of systemic therapies is crucial.
Finally, to seek appropriate experience. If physicians are uncertain in managing AD, they should seek out those who have experience and can guide them.
Overall, with timely intervention, modern therapies, and tailored and individualised treatment goals, the future for patients with AD and those managing it looks to be promising.
Wollenberg A et al. Patient-reported burden in adults with atopic dermatitis: an international qualitative study. Arch Dermatol Res. 2024;316(7):380.2
Simpson EL et al. Association of inadequately controlled disease and disease severity with patient-reported disease burden in adults with atopic dermatitis. JAMA Dermatol. 2018;154(8):903-12.
Eyerich K et al. Real-world clinical, psychosocial and economic burden of atopic dermatitis: results from a multicountry study. J Eur Acad Dermatol Venerol. 2024;38(2):340-53.
Romiti R et al. Cumulative life course impairment in patients with dermatological diseases, with a focus on psoriasis. An Bras Dermatol. 2024;99(2):269-76.
De Bruin-Weller MS et al. Real-world achievement of atopic dermatitis treat-to-target disease domain criteria: results from a multicountry study. Poster 185. RAD Conference, 9-11 April, 2022.
Silverberg JI et al. Combining treat-to-target principles and shared decision-making: international expert consensus-based recommendations with a novel concept for minimal disease activity criteria in atopic dermatitis. J Eur Acad Dermatol Venereol. 2024;38(11):2139-48.
Machovcova A et al. Atopic dermatitis: current guidelines for diagnosis and treatment. Part II.
Czech-Slovak Derm. 2023;98(3):123-49.AAAeIC. Guía Argentina de práctica clínica orientada a la terapéutica de niños/as, adolescentes y adultos con dermatitis atópica. 2024. Available at: https://sad.org.ar/wp-content/uploads/2024/04/Guia-Argentina-de-practica-clinica-orientada-a-la-terapeutica -de-ninosas-adolescentes-y-adultos-con-Dermatitis-Atopica-2024.pdf. Last accessed: 21 October 2025. Yao X et al. Expert consensus on the stratified individualized systemic therapy of atopic dermatitis.
Yao X et al. Expert consensus on the stratified individualized systemic therapy of atopic dermatitis. Chin J Dermatol. 2024;57(12):1071-8.
Ameen A et al. Correction: consensus recommendations for the management of atopic dermatitis in the United Arab Emirates. Dermatol Ther (Heidelb). 2024;14(10):2927-8.
Gkini MA et al. Set targets, assess response, intervene early to achieve minimal disease activity in atopic dermatitis (STRIVE AD): a modified Delphi consensus project to optimize management of atopic dermatitis in the United Kingdom. JAAD International. 2026;25:56-68.
Silverberg JI et al. Impact of achieving optimal treatment targets and minimal disease activity on health-related quality of life and satisfaction in patients with atopic dermatitis. Dermatol Ther (Heidelb). 2025;15(8):2255-73.
Silverberg JI et al. Flare occurrence and healthcare resource utilization among patients who achieve minimal disease activity in atopic dermatitis: results from a real-world multi-country study. Poster 63852. AAD Annual Meeting, 7-11 March, 2025.
References
Binamer acknowledged that some physicians may be reluctant to adopt the AHEAD approach, perceiving it as time-consuming. However, he emphasised that the structured approach facilitates clinical efficiency. By identifying the patient’s most burdensome symptom and setting goals with them, clinicians can use continual evaluation for consistent monitoring of patient response to treatment.
Gkini elaborated that it is crucial for treating physicians to inform patients about their available options and the potential that they have to achieve clear or almost clear skin. Often, patients present in clinic with severe disease, but they report being happy, and are reluctant to change treatment, since they were much worse before.
Gkini and Binamer agreed that the AHEAD approach and aiming for MDA have helped shape their approach to AD management.
As clinics are often busy, utilising the AHEAD approach helps to streamline appointments and ensure that every minute spent with the patient is as useful as possible.
Both Gkini and Binamer use EASI scores when assessing patients, and suggest that within the clinic, physicians retain familiarity with a specific assessment tool, which can be EASI, ScORing Atopic Dermatitis (SCORAD), or Investigator Global Assessment (IGA) and Body Surface Area (BSA), using it across the entire patient follow-up period.
Binamer also explained that patients who achieve MDA will spend less time attending the clinic, which eases pressure on busy healthcare professionals and saves money in the longer term, both for the patients themselves and the practice as a whole.
Binamer elaborated that a high number of flares and subsequent use of healthcare services result in a significant burden on already-strained clinics. He continued to explain that patients with controlled disease have fewer appointments, resulting in lower utilisation of healthcare services.
Moreover, Binamer emphasised the importance of sharing a rescue plan with patients, explaining what they should do in case of flares if they are unable to see a physician, thereby freeing up time in the clinic for newly presenting patients.
He emphasised that less time spent with doctors means patients can spend more time living their lives.
Gkini noted that not all patients with AD may be able to achieve MDA, but it should be seen as an optimal goal, in alignment with the AHEAD recommendations.6,12
These data demonstrate that patients who achieve MDA experience optimal quality of life improvements across multiple dimensions of their lives, thereby underscoring the importance of aiming for higher treatment targets when treating patients with AD.12
Neither Optimal Target Achieved
MDA Achieved
4.4%
72.6%
Neither Optimal Target Achieved
MDA Achieved
19.7%
98.1%
Neither Optimal Target Achieved
MDA Achieved
16.3%
89.1%
Neither Optimal Target Achieved
MDA Achieved
14.5%
81.6%
Neither Optimal Target Achieved
MDA Achieved
53.1%
97.1%
Neither Optimal Target Achieved
MDA Achieved
12.0%
98.8%
Neither Optimal Target Achieved
MDA Achieved
27.4%
82.4%
He continued, explaining: “However, if we are not achieving these goals, we need to either modify the management plan or look again and discuss with our patient.”
Per the AHEAD recommendations, treatment modification or escalation should be considered if treatment targets are not met within 3–6 months.6
Treatment initiation
MDA not achieved
3-6 months
(Continued management)
(Re-evaluate management plan)
MDA achieved
Gkini explained that by using the AHEAD and STRIVE-AD recommendations, rather than just managing symptoms as and when they arise, clinicians and patients can work towards clearly defining specific treatment goals, short-term and long-term, and optimise treatment when goals are not achieved.
Patients who achieve MDA experience worse quality of life outcomes
Patients who achieve MDA experience the greatest levels of improvement across multiple quality of life domains
Patients who achieve MDA only experience improvements in daily activities and work productivity
Which of the following is true regarding patients with AD who achieve MDA, compared to patients who do not achieve MDA?
QUESTION
Achievement of EASI 90 + WP-NRS 0/1
*Targets are for all AD severities, unless otherwise specified. Both ‘moderate’ and higher ‘optimal’ targets were developed to reflect that optimal targets may not be currently achievable in all patients and all parts of the world due to availability and access to advanced treatment options. Achievement of ‘optimal’ targets is defined as MDA.
Adapted from Silverberg et al.6
AD: atopic dermatitis; BSA: body surface area; CDLQI: Children’s DLQI; DLQI: Dermatology Life Quality Index; EASI: Eczema Area and Severity Index; EASI-75/90: 75%/90% improvement in EASI; HADS: Hospital Anxiety and Depression Scale; HADS-A: HADS-Anxiety; HADS-D: HADS-Depression; IDQOL: Infants’ Dermatitis Quality of Life; IGA: Investigator’s Global Assessment; MDA: minimal disease activity; NRS: Numeric Rating Scale; POEM: Patient-Oriented Eczema Measure; SCORAD: SCORing Atopic Dermatitis.
Table 1: Recommended treatment targets for patient-reported and clinician-reported measures.*6
In a global patient research survey carried out to evaluate the burden of AD, over 75% of patients reported itch, skin redness, dry/flaky skin, and sleep disturbance every 1–3 days, with more than half reporting mental health issues at least 2–3 times a month.1
These impacts can persist despite treatment, with 56% of patients still reporting sub-optimally controlled disease.2
In patients treated with systemic therapy, the burden of AD can extend beyond the physical signs and symptoms, including sleep disturbances multiple nights per week, frequent flares, multiple healthcare appointments, and impairment of work productivity and activity.
Those impacts worsen with increasing disease severity levels,3 and may accumulate over the life course of a patient living with AD.4
In addition to skin lesions, itch is a commonly reported symptom that can have many psychosocial consequences.
Both Binamer and Gkini agreed that pruritus, or itch, is the most commonly reported and most burdensome symptom for patients with AD.
Support: The publication of this article was sponsored by AbbVie.
Interviewees: Yousef Binamer,1 Maria-Angeliki Gkini2
1. Department of Dermatology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
2. Barts Health NHS Trust, London, UK
Disclosure: Binamer has received honoraria and/or served as a consultant or advisor for AbbVie, Sanofi, Eli Lilly, Janssen, Novartis, Kyowa Kirin, and NewBridge; and received research grants from Novartis and Sanofi. Gkini has been an investigator for, and/or has served as an advisory board member and/or speaker, or has received education support and/or travel grants from NIHR studies, AbbVie, Novartis, Johnson & Johnson, Almirall, LEO Pharma, UCB, Pharmaserve-Lilly, Sanofi, Pfizer, Faran, AMGEN, Argenx, Bristol Myers Squibb, Oruka Therapeutics, Frezyderm, Pierre Fabre, Galderma, L’Oreal, Hair+Me, and Beiersdorf.
Disclaimer: The opinions expressed in this article belong to the named interviewees.
Acknowledgements: Medical writing assistance and interactivity support was provided by Yolande Chalmers, EMJ, London, UK.
Keywords: Atopic dermatitis (AD), burden of disease, clinician-reported outcome (ClinRO), daily activities, emotional state, health-related quality of life (HrQoL), minimal disease activity (MDA), optimal treatment targets, patient-reported outcomes (PRO), sleep, work productivity.
Original citation: EMJ Dermatol. 2025;13[Suppl 4]:2-9. https://doi.org/10.33590/emjdermatol/GXFD9273
The burden of disease and unmet needs in atopic dermatitis
The aiming high in eczema/atopic dermatitis approach: Aiming for minimal disease activity
What does achieving optimal treatment targets and minimal disease activity mean for patients?
What does achieving optimal treatment targets and minimal disease activity mean for physicians?
How do clinicians implement the aiming high in eczema/atopic dermatitits approach and miniml disease activity in real-world clinincal practice
What does the future hold for patients with atopic dermatitis?
Patients who achieve MDA experience the greatest levels of improvement across multiple quality of life domains
x
EASI
SCORAD
IGA and BSA
Itch
Sleep
Quality of life
Daily activities
Emotional state
Work productivity
Treatment satisfaction
Other skin symptoms
% of Patients Achieving DLQI 0/1* Response When...
% of Patients Achieving ADerm-IS daily activity 0-2‡ Response When...
% of Patients Achieving Sleep NRS 0/1†
Response When...
% of Patients Achieving ADerm-IS emotional state 0-2‡ Response When...
% of Patients Achieving
Work productivity improvement§ Response When...
% of Patients Achieving Treatment satisfaction** Response When...
% of Patients Achieving ADerm-SS skin symptoms 0-11** Response When...
VS
VS
VS
VS
VS
VS
VS
% of Patients
Achieving WP-NRS 0/1* Response When...
Neither Optimal Target Achieved
VS
MDA Achieved
0%
100%
In his clinical practice, Binamer explained: “We always ask the patient, ‘What is most bothersome of your symptoms?’ We want this from the perspective of the patient, and then from the perspective of the clinician.”
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Adapted from Silverberg et al13
Figure 2: Effect of achievement of minimal disease activity or neither optimal target on patient health-related quality of life12
Atopic dermatitis (AD) is a common, chronic inflammatory skin disease that presents heterogeneously across patients. It carries a high disease burden, with symptoms such as pruritus (itch) severely affecting patients’ quality of life. Despite advances in AD treatments, patients who are sub-optimally managed may continue to experience residual disease burden. Novel frameworks for AD management, such as the Aiming High in Eczema/Atopic Dermatitis (AHEAD) consensus recommendations, as well as clinical guidelines and consensus statements in different countries, advocate aiming for higher treatment goals, such as minimal disease activity (MDA). MDA represents the concomitant achievement of optimal treatment targets on both a clinician-reported outcome (ClinRO) and a patient-reported outcome (PRO). Achievement of MDA is associated with better PROs and improvement in quality of life compared to patients who do not achieve it. In addition, patients who achieve MDA experience fewer, shorter flares, and fewer healthcare visits compared to those who do not achieve MDA. Recent research discussed in this article by experts Yousef Binamer, Chairman, Department of Dermatology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; and Maria-Angeliki Gkini, Consultant Dermatologist at Barts Health NHS Trust, London, UK, can help the dermatology community to better understand the value of achieving MDA, paving the way to advancing the standard of care in atopic dermatitis.
Maria-Angeliki Gkini
Barts Health NHS Trust, London, UK
Yousef Binamer
Department of Dermatology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
Analyses were based on available data for each outcome. Sample size may vary depending on data availability of the measures involved.
*For patients with baseline score >1. †ADerm-IS item no. 2 sleep 0/1 among those with baseline score >1.
‡Among those with a baseline score >2.
§WPAI overall work impairment ≥20-point improvement among those with a baseline score ≥20.
**Patient Global Impression of Treatment reporting “extremely satisfied” or “very satisfied.”
††Among those with baseline score >11.
Adapted from Silverberg et al.12
ADerm-IS: Atopic Dermatitis Impact Scale; ADerm-SS: Atopic Dermatitis Symptom Scale; DLQI: Dermatology Life Quality Index; EASI: Eczema Area and Severity Index; MDA: minimal disease activity; NRS: Numerical Rating Scale; WP-NRS: Worst Pruritus Numerical Rating Scale.
Interview Summary