Treatment following an evidence-based algorithm versus individualised symptom-oriented treatment for atopic eczema: A randomised controlled trial

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

Abstract

Background: Evidence-based treatment algorithms, successfully established for asthma, are missing for atopic eczema (AE). Objectives: To investigate whether treatment according to an evidence-based algorithm is an effective and applicable concept for the management of AE. Methods: Based on a systematic literature review, we developed an evidence-based severity-score-oriented treatment algorithm for AE and compared its effectiveness to that of an individualised symptom-oriented treatment (individual therapy) in a randomised controlled trial. Sixty-three participants were randomised to algorithm (n = 32) or individual therapy (n = 31) and treated accordingly for 12 months. Study end points included difference between baseline SCORAD and mean SCORAD under treatment (primary end point), quality of life and treatment utilisation. Analysis was by intention to treat (registration: ClinicalTrials.gov: NCT00148746). Results: No statistically significant differences in clinical or subjective response were observed between groups. Treatment following the algorithm and individual treatment both effectively controlled AE. Mean SCORAD reductions were 47% (95% confidence interval, CI = 38-55; algorithm) and 42% (95% CI = 29-54; individual). Clinical response was paralleled by improved quality of life in both groups. Physicians adhered to the algorithm option in 93% of their treatment decisions. Conclusion: Treatment following an evidence-based algorithm is an effective and applicable concept for the management of AE but does not show clear advantages compared to individualised treatment in a dermatological setting.

Details

OriginalspracheEnglisch
Seiten (von - bis)299-308
Seitenumfang10
FachzeitschriftDermatology : international journal for clinical and investigative dermatology
Jahrgang217
Ausgabenummer4
PublikationsstatusVeröffentlicht - Nov. 2008
Peer-Review-StatusJa

Externe IDs

PubMed 18703875

Schlagworte

ASJC Scopus Sachgebiete

Schlagwörter

  • Atopic dermatitis, Atopic eczema, Long-term control, Randomized controlled trial, Topical calcineurin inhibitors, Topical corticosteroids, Treatment algorithm

Bibliotheksschlagworte