Redefining Treat-to-target in Atopic Dermatitis: Towards Meaningful, Patient-centred Disease Control – An ISAD Position Paper

Authors

  • John Su Department of Dermatology, Monash University, Eastern Health and Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia; International Society of Atopic Dermatitis (ISAD), Davos, Switzerland
  • Andreas Wollenberg International Society of Atopic Dermatitis (ISAD), Davos, Switzerland; Department of Dermatology and Allergy, University Hospital Augsburg, Augsburg, Germany; Comprehensive Center for Inflammation Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany
  • Melanie Funk Eczema Support Australia, Hope Island, Australia
  • Tina Mesarič Institute Atopika, Maribor, Slovenia
  • Brandon Hu Department of Dermatology, Monash University, Eastern Health and Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia; Independent patient representative and physician trainee, Melbourne, Australia
  • Tammi Shipowick GlobalSkin, Ottawa, Canada
  • Kelly Barta International Topical Steroid Awareness Network (ITSAN), Atlanta, GA, United States
  • Kristin Belleson National Eczema Association, Novato, CA, United States
  • Li-Chuen Wong Department of Dermatology, The Children’s Hospital at Westmead, Sydney, Australia
  • Kiu Han Kim Department of Dermatology, VHS Medical Center, Seoul, South Korea
  • Chia-Yu Chu Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
  • Sandipan Dhar International Society of Atopic Dermatitis (ISAD), Davos, Switzerland; Department of Pediatric Dermatology, Kolkata, India
  • Yoshiyuki Kataoka Department of Dermatology, Osaka Habikino Medical Center, Osaka, Japan
  • Kin Fon Leong Department of Dermatology, Kuala Lumpur, Malaysia
  • Kam Lun Ellis Hon Department of Pediatrics, CUHK Medical Centre, The Chinese University of Hong Kong, Hong Kong, China
  • Erere Otrofanowei International Society of Atopic Dermatitis (ISAD), Davos, Switzerland; Dermatology Unit, Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
  • Peter Foley Department of Dermatology, Monash University, Eastern Health and Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia; Skin Health Institute and The University of Melbourne, Melbourne, Australia
  • Lin Ma International Society of Atopic Dermatitis (ISAD), Davos, Switzerland; Department of Dermatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
  • Yong Kwang Tay Department of Dermatology, Changi General Hospital, Singapore, Singapore
  • Marie Lodén Department of Dermatology and Pharmacy, Stockholm, Sweden
  • Anousha Yazdabadi Department of Dermatology, Eastern Health Clinical School, Monash Medical School, Monash University, Melbourne, Australia
  • Kathrin A. Gibson Department of Rheumatology, Liverpool Hospital, Sydney, Australia
  • Jonathan D. Akikusa Rheumatology Service, Department of General Medicine, Royal Children’s Hospital, Melbourne, Australia
  • Andrew Östör Rheumatology Service, Department of General Medicine, Royal Children’s Hospital, Melbourne, Australia
  • Connie Katelaris Allergy and Immunology Unit, Department of Medicine, Campbelltown Hospital, Sydney, Australia
  • Frank Thien Department of Respiratory Medicine, Monash University, Eastern Health, Melbourne, Australia
  • Michihiro Futamura Department of Pediatrics and Allergy, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
  • Rie Yotsu Department of Tropical Medicine and Infectious Disease, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
  • Peter Schmid-Grendelmeier International Society of Atopic Dermatitis (ISAD), Davos, Switzerland; Allergy Unit, Department of Dermatology, University Hospital Zurich, Switzerland, Davos; CK-CARE, Davos, Switzerland
  • Alain Taïeb International Society of Atopic Dermatitis (ISAD), Davos, Switzerland https://orcid.org/0000-0002-0928-8608

DOI:

https://doi.org/10.2340/actadv.v106.10.2340/adv-2026-0868

Keywords:

atopic dermatitis, treat-to-target, patient-centered care, disease control, patient-reported outcomes, minimal disease activity

Abstract

Treat-to-target strategies link predefined goals to regular assessment and treatment adaptation. In atopic dermatitis, recent initiatives have mainly defined thresholds using clinician- and patient-reported outcomes. This review and position paper critically examines current approaches and proposes priorities for a more clinically meaningful, patient-centred and globally applicable framework. It synthesizes recent consensus and outcome-harmonization initiatives with selected lessons from rheumatoid arthritis and asthma and was informed by multidisciplinary, patient-inclusive discussions at an International Society of Atopic Dermatitis-World Health Organization premeeting. The workshop was not a Delphi or formal consensus exercise; it was used to identify conceptual priorities and implementation challenges for future international consensus work. Current proposals converge partly around severity thresholds and symptom control but insufficiently capture disease instability, comorbidities, family burden, treatment burden and real-world constraints. We propose 4 complementary domains: disease activity; symptoms and function; global patient health and disease impact and longitudinal control and treatment adaptation. Some components are supported by validated measures, whereas others remain exploratory. Treat-to-target in atopic dermatitis should evolve beyond isolated thresholds towards an adaptable multidimensional strategy, followed by formal international consensus and prospective validation.

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Published

2026-08-11

How to Cite

Su, J., Wollenberg, A., Funk, M., Mesarič, T., Hu, B., Shipowick, T., … Taïeb, A. (2026). Redefining Treat-to-target in Atopic Dermatitis: Towards Meaningful, Patient-centred Disease Control – An ISAD Position Paper. Acta Dermato-Venereologica, 106, adv–2026. https://doi.org/10.2340/actadv.v106.10.2340/adv-2026-0868

Issue

Vol. 106 (2026)

Section

Review

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