Expert opinion on management of moderate-to-severe atopic dermatitis in Qatar

Abstract

Atopic dermatitis (AD), a chronic-relapsing inflammatory skin disorder, manifests with intense itching and eczematous lesions impairing quality of life. A heterogeneous population, and regional clinical practices for treating AD warrant the development of guidelines in Qatar. Therefore, guidelines for the management of moderate-to-severe AD in Qatar have been developed and discussed. Experts, including dermatologists and immunologists, used the Delphi technique for developing guidelines. Consensus was defined as ≥75% agreement or disagreement. AD is highly prevalent in primary and tertiary dermatology centers. AD-associated foot eczema and psoriasiform eczema are more frequent in Qatar than in Europe or USA. SCORing Atopic Dermatitis Index quantifies disease severity and itch. Dermatology Life Quality Index assesses the quality of life. Atopic Dermatitis Control Tool assesses long-term disease control. Moderate-severe AD benefits from new topicals like Janus-kinase-inhibitors or PDE4-inhibitors combined with phototherapy. Currently approved systemic agents are dupilumab, baricitinib, abrocitinib, and upadacitinib. New anti-IL-13 and anti-IL-31 therapies will soon be available. Patient education, allergy testing, and comorbidity consideration are critical in the management of AD. The expert panel established a comprehensive and pragmatic approach to managing moderate-to-severe AD, thereby assisting clinical decision-making for healthcare professionals in Qatar.

Keywords:

• Atopic dermatitis
• consensus
• biologics
• dupilumab
• JAK-inhibitor
• treatment

Acknowledgments

Open access funding is provided by the Qatar National Library. Editorial support for this manuscript preparation was provided by BioQuest Solutions.

Author contributions

All authors made a significant contribution to the work reported, whether in the conception, study design, execution, acquisition of data, analysis, and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; agreed on the journal to which the article has been submitted; and agreed to be accountable for all aspects of the work.

Disclosure statement

Martin Steinhoff acknowledged receipt of consultancy fees from AbbVie, Pfizer, Eli Lilly, Novartis, Sanofi, Biologix, Algorithm, Bayer, BMS, Chugai Pharmaceuticals, Toray Industries, Maruho, GSK, Kiniksa Pharmaceuticals, Leo Pharma, Pierre-Fabre, and Almirall. He received advisory board fees from AbbVie, Pfizer, Eli Lilly, Novartis, Sanofi, BMS, Chugai Pharmaceuticals, Toray Industries, Maruho, Leo Pharma, Pierre-Fabre, and Almirall. He also received research funding from AbbVie, Pfizer, Novartis, Bayer, BMS, Chugai Pharmaceuticals, Toray Industries, Maruho, Leo Pharma, Pierre-Fabre, and Almirall. Adel Mohamed Kamal, Ahmad Hazem, Hassan Riad, Mehdi Adeli, Mohamed Allam, Ra’ed Alsmadi, Waad Ibrahim, and Maryam Ali Al-Nesf do not have any conflicts of interest with respect to this manuscript.

Data availability statement

No underlying data were collected or produced for this manuscript.

Authorship

All the listed authors are final and there are no changes to the authorship. We have included the rest of the contributors who do not qualify for authorship in the acknowledgments. Author contribution is also listed in the manuscript.

Additional information

Funding

Sanofi provided funding for logistic support for the development of this manuscript.