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The updated guidelines standardize atopic eczema care, ensuring personalized, evidence-based treatment to optimize patient outcomes.
In a significant advancement for dermatological care, EuroGuiDerm, the European guideline on atopic eczema (dermatitis), published in 2022, offers a detailed framework for managing this chronic skin condition across all age groups.
Devised by A. Wollenberg and colleagues, this set of guidelines has been released following four rigorous consensus conferences bringing together experts (leading clinicians and patient representatives) from all over Europe to frame a unified approach to treating this chronic skin condition.
The first part of the guideline provides a comprehensive overview, outlining its scope, objectives, and the key health questions it addresses. It also highlights the target audience—clinicians, healthcare providers, etc.—and researches the approaches used in shaping the guidelines.
Emphasizing the expert recommendations for systemic treatments, the ideal candidates are specified and comprehensive information on available medications, dosages, and treatment choices has been mentioned:
Standard Immunosuppressive Therapies:
Dosage: 1–3 mg/kg body weight per day. If no improvement occurs within 3 months, discontinuation should be considered.
Dosage: 2.5 mg/kg body weight per day. Treatment duration should be limited to 12 months. Concomitant use with topical therapies is recommended. Avoid combining with UV light therapies due to an increased risk of skin cancer.
Dosage: For acute flares, a starting dose of 0.5 mg/kg body weight per day is recommended. Treatment should be discontinued or tapered as soon as possible. Long-term use is not advised as it may cause side effects.
Dosage: 15 mg per week, adjusted based on patient response and tolerance. Routine assessment of liver function and blood counts is necessary.
Dosage: 1–2 g per day, divided as two doses. Screen for gastrointestinal side effects and blood counts.
Biologics:
Dosage: Subcutaneous injection (SC) of 600 mg initially, followed by 300 mg every other week.
Dosage: 600 mg SC injection given initially, followed by 300 mg every four weeks.
Dosage: 180 mg every four weeks. Administered via SC injection.
Dosage: Dosing is based on body weight and IgE levels at the beginning. Administered as a SC injection every two to four weeks.
Dosage: 300 mg every two weeks. Administered via SC injection.
Janus Kinase (JAK) Inhibitors:
Dosage: 100 mg once daily. If inadequate response after 12 weeks, increase to 200 mg once daily.
Dosage: 2 mg once daily. Screen for infections and blood counts.
Dosage: 15 mg once daily. If inadequate response after 12 weeks, increase to 30 mg once daily.
These recommendations mark a pivotal step towards standardizing atopic eczema management, ensuring clinicians have the latest tools and knowledge to optimize patient outcomes across Europe.
Journal of the European Academy of Dermatology & Venereology
European guideline (EuroGuiDerm) on atopic eczema: part I – systemic therapy
A. Wollenberg et al.
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