48-Week Real-World Atopic Dermatitis Study on Minimal Disease Activity, Associated Factors, and Agreement Between Clinician- and Patient-Reported Outcomes
- 1Dermatology Department, Hospital Universitario Virgen de Las Nieves, Avenida de Madrid 15, 18012 Granada, Spain
- 2Instituto de Investigación Biosanitaria Ibs.GRANADA, 18012 Granada, Spain
- 3Dermatology Department, School of Medicine, University of Granada, 18016 Granada, Spain
Abstract
Introduction: Atopic dermatitis (AD) requires multidimensional assessment strategies that integrate clinician and patient perspectives. Minimal disease activity (MDA) has emerged as a treatment target, although its optimal definition and real-world determinants remain unclear. This study aimed to evaluate the proportion of patients achieving MDA under advanced therapies (ATs), identify associated factors, assess agreement between clinician-reported outcomes (CROs) and patient-reported outcomes (PROs), and propose a pragmatic operational definition of MDA.
Methods: Prospective observational study including patients ≥ 12 years with moderate-to-severe AD initiating AT (biologics or JAK inhibitors) in routine clinical practice. Assessments were performed at baseline and weeks 16, 24, and 48. MDA was defined as the simultaneous achievement of ≥ 1 CRO and ≥ 1 PRO using established cutoffs. Multivariable logistic regression was used to identify factors associated with MDA. Agreement analyses between outcomes were performed, and candidate MDA definitions were validated against external instruments.
Results: Ninety-six patients were included. MDA was achieved by 42.7%, 52.6%, and 46.0% of patients at weeks 16, 24, and 48, respectively. Lower baseline disease severity, fewer prior systemic treatments, and fewer AD-related comorbidities were associated with achieving MDA (p < 0.05). Agreement was high among CROs, more variable among PROs, and lower between CROs and PROs. The combination of Eczema Area and Severity Index (EASI) ≤ 3 and Dermatology Life Quality Index (DLQI) 0/1 showed the best performance across validation measures.
Conclusions: ATs are effective in achieving MDA in AD. A composite definition integrating EASI ≤ 3 and DLQI 0/1 may represent a practical and clinically useful definition for routine clinical practice.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s13555-026-01924-6.
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BibTeX
@article{rodriguezsanna202648week,
title = {{48-Week Real-World Atopic Dermatitis Study on Minimal Disease Activity, Associated Factors, and Agreement Between Clinician- and Patient-Reported Outcomes}},
author = {Andrea I. Rodriguez-Sanna and Carmen García-Moronta and Julia Castro-Martin and Clara A. Ureña-Paniego and Salvador Arias-Santiago and Trinidad Montero-Vilchez},
journal = {Dermatology and Therapy},
year = {2026},
month = sep,
doi = {10.1007/s13555-026-01924-6},
url = {https://doi.org/10.1007/s13555-026-01924-6},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - 48-Week Real-World Atopic Dermatitis Study on Minimal Disease Activity, Associated Factors, and Agreement Between Clinician- and Patient-Reported Outcomes
AU - Andrea I. Rodriguez-Sanna
AU - Carmen García-Moronta
AU - Julia Castro-Martin
AU - Clara A. Ureña-Paniego
AU - Salvador Arias-Santiago
AU - Trinidad Montero-Vilchez
PY - 2026
DA - 2026/09/01
JO - Dermatology and Therapy
DO - 10.1007/s13555-026-01924-6
UR - https://doi.org/10.1007/s13555-026-01924-6
AB - Introduction: Atopic dermatitis (AD) requires multidimensional assessment strategies that integrate clinician and patient perspectives. Minimal disease activity (MDA) has emerged as a treatment target, although its optimal definition and real-world determinants remain unclear. This study aimed to evaluate the proportion of patients achieving MDA under advanced therapies (ATs), identify associated factors, assess agreement between clinician-reported outcomes (CROs) and patient-reported outcomes (PROs), and propose a pragmatic operational definition of MDA. Methods: Prospective observational study including patients ≥ 12 years with moderate-to-severe AD initiating AT (biologics or JAK inhibitors) in routine clinical practice. Assessments were performed at baseline and weeks 16, 24, and 48. MDA was defined as the simultaneous achievement of ≥ 1 CRO and ≥ 1 PRO using established cutoffs. Multivariable logistic regression was used to identify factors associated with MDA. Agreement analyses between outcomes were performed, and candidate MDA definitions were validated against external instruments. Results: Ninety-six patients were included. MDA was achieved by 42.7%, 52.6%, and 46.0% of patients at weeks 16, 24, and 48, respectively. Lower baseline disease severity, fewer prior systemic treatments, and fewer AD-related comorbidities were associated with achieving MDA (p < 0.05). Agreement was high among CROs, more variable among PROs, and lower between CROs and PROs. The combination of Eczema Area and Severity Index (EASI) ≤ 3 and Dermatology Life Quality Index (DLQI) 0/1 showed the best performance across validation measures. Conclusions: ATs are effective in achieving MDA in AD. A composite definition integrating EASI ≤ 3 and DLQI 0/1 may represent a practical and clinically useful definition for routine clinical practice. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s13555-026-01924-6.
SN - 2193-8210
SN - 2190-9172
ER -