背景:自2014年指南以来,出现了新的证据,进一步告知了局部治疗AD的管理。这些指南更新了2014年通过局部疗法治疗特应性皮炎(AD)的建议。
目的:提供与成人局部治疗AD相关的循证建议。
方法:一个多学科工作组进行了系统审查,并应用GRADE方法来评估证据的确定性以及制定和分级建议。
结果:工作组就局部治疗成人AD的管理提出了11项建议,包括非处方药和处方外用皮质类固醇(TCS),钙调磷酸酶抑制剂(TCI),Janus激酶(JAK)抑制剂,磷酸二酯酶-4抑制剂(PDE-4),抗菌药物,和抗组胺药.
结论:将文献综述限制为英语随机试验的务实决定可能排除了以其他语言发表的数据和相关的长期随访数据。
结论:对使用保湿剂提出了强有力的建议,TCI,TCS,和局部PDE-4和JAK抑制剂。有条件地建议使用沐浴和湿巾疗法,并反对使用局部抗菌剂,防腐剂,和抗组胺药.
New evidence has emerged since the 2014
guidelines that further informs the management of atopic dermatitis (AD) with topical therapies. These
guidelines update the 2014 recommendations for management of AD with topical therapies.
To provide evidence-based recommendations related to management of AD in adults using topical treatments.
A multidisciplinary workgroup conducted a systematic review and applied the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach for assessing the certainty of evidence and formulating and grading recommendations.
The workgroup developed 12 recommendations on the management of AD in adults with topical therapies, including nonprescription agents and prescription topical corticosteroids (TCS), calcineurin inhibitors (TCIs), Janus kinase (JAK) inhibitors, phosphodiesterase-4 inhibitors (PDE-4), antimicrobials, and antihistamines.
The pragmatic decision to limit the literature review to English-language randomized trials may have excluded data published in other languages and relevant long-term follow-up data.
Strong recommendations are made for the use of moisturizers, TCIs, TCS, and topical PDE-4 and JAK inhibitors. Conditional recommendations are made for the use of bathing and wet wrap therapy and against the use of topical antimicrobials, antiseptics, and antihistamines.