Updated consensus guidelines for management of moderate-to-severe atopic dermatitis in Singapore: Integrating biologics, Janus kinase inhibitors and conventional therapies

Introduction: Since 2016, several therapies have been approved for treating atopic dermatitis (AD) in Singapore, including biologics, oral Janus kinase (JAK) inhibitors and topical crisaborole. This study supplements the 2016 Singapore treatment guidelines for AD, focusing on newer therapies for mo...

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Main Authors: Yik Weng Yew, Uma Alagappan, Derrick Aw, Suyien Chandran, Karen JL Choo, Roland Chu, Hong Yi Koh, Mark Jean Aan Koh, Shan Xian Lee, Ching Yin Neoh, Siyun Lucinda Tan, Mark Tang, Yong-Kwang Tay, Seth Francis-Graham, Andrew Lim, Haur Yueh Lee
Format: Article
Language:English
Published: Academy of Medicine Singapore 2024-11-01
Series:Annals, Academy of Medicine, Singapore
Online Access:https://annals.edu.sg/updated-consensus-guidelines-for-management-of-moderate-to-severe-atopic-dermatitis-in-singapore-integrating-biologics-janus-kinase-inhibitors-and-conventional-therapies/
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author Yik Weng Yew
Uma Alagappan
Derrick Aw
Suyien Chandran
Karen JL Choo
Roland Chu
Hong Yi Koh
Mark Jean Aan Koh
Shan Xian Lee
Ching Yin Neoh
Siyun Lucinda Tan
Mark Tang
Yong-Kwang Tay
Seth Francis-Graham
Andrew Lim
Haur Yueh Lee
author_facet Yik Weng Yew
Uma Alagappan
Derrick Aw
Suyien Chandran
Karen JL Choo
Roland Chu
Hong Yi Koh
Mark Jean Aan Koh
Shan Xian Lee
Ching Yin Neoh
Siyun Lucinda Tan
Mark Tang
Yong-Kwang Tay
Seth Francis-Graham
Andrew Lim
Haur Yueh Lee
author_sort Yik Weng Yew
collection DOAJ
description Introduction: Since 2016, several therapies have been approved for treating atopic dermatitis (AD) in Singapore, including biologics, oral Janus kinase (JAK) inhibitors and topical crisaborole. This study supplements the 2016 Singapore treatment guidelines for AD, focusing on newer therapies for moderate-to-severe disease, while revisiting older treatment regimens to accommodate changes in knowledge and practice. Method: A modified Delphi panel was held, led by 2 co-chairs. The voting expert panel consisted of 12 dermatologists experienced in managing AD in Singapore. Delphi survey rounds were conducted between 24 July and 27 October 2023. Panellists indicated their agreement with drafted statements using a 5-point Likert scale. Consensus was defined as ≥80% agreement. An expert meeting was held to facilitate the consensus process between rounds 1 and 2 of voting. Results: All expert panellists participated in both survey rounds, with a 100% response rate. Thirty-nine statements, classified into general principles, conventional treatments, biologics and JAK inhibitors, were proposed. Of these, 27 statements reached consensus at the end of round 1. After the expert meeting, 17 statements were included in round 2, of which 16 statements reached consensus. One statement did not reach consensus. Key updates are the inclusion of dupilumab and JAK inhibitors as potential first-line treatments for moderate-to-severe AD, in certain populations. Conclusion: This modified Delphi study generated consensus among Singapore dermatology experts, to update treatment guidelines in moderate-to-severe atopic dermatitis. The consensus statements developed are intended to supplement the 2016 Singapore treatment guidelines for AD. Further revisions may be required when new evidence and/or treatments become available.
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spelling doaj-art-523c06182b7c48359c036a0bca4aa56a2024-12-03T01:17:52ZengAcademy of Medicine SingaporeAnnals, Academy of Medicine, Singapore2972-40662024-11-01531167068210.47102/annals-acadmedsg.2024158Updated consensus guidelines for management of moderate-to-severe atopic dermatitis in Singapore: Integrating biologics, Janus kinase inhibitors and conventional therapiesYik Weng YewUma AlagappanDerrick AwSuyien ChandranKaren JL ChooRoland ChuHong Yi KohMark Jean Aan KohShan Xian LeeChing Yin NeohSiyun Lucinda TanMark TangYong-Kwang TaySeth Francis-GrahamAndrew LimHaur Yueh Lee Introduction: Since 2016, several therapies have been approved for treating atopic dermatitis (AD) in Singapore, including biologics, oral Janus kinase (JAK) inhibitors and topical crisaborole. This study supplements the 2016 Singapore treatment guidelines for AD, focusing on newer therapies for moderate-to-severe disease, while revisiting older treatment regimens to accommodate changes in knowledge and practice. Method: A modified Delphi panel was held, led by 2 co-chairs. The voting expert panel consisted of 12 dermatologists experienced in managing AD in Singapore. Delphi survey rounds were conducted between 24 July and 27 October 2023. Panellists indicated their agreement with drafted statements using a 5-point Likert scale. Consensus was defined as ≥80% agreement. An expert meeting was held to facilitate the consensus process between rounds 1 and 2 of voting. Results: All expert panellists participated in both survey rounds, with a 100% response rate. Thirty-nine statements, classified into general principles, conventional treatments, biologics and JAK inhibitors, were proposed. Of these, 27 statements reached consensus at the end of round 1. After the expert meeting, 17 statements were included in round 2, of which 16 statements reached consensus. One statement did not reach consensus. Key updates are the inclusion of dupilumab and JAK inhibitors as potential first-line treatments for moderate-to-severe AD, in certain populations. Conclusion: This modified Delphi study generated consensus among Singapore dermatology experts, to update treatment guidelines in moderate-to-severe atopic dermatitis. The consensus statements developed are intended to supplement the 2016 Singapore treatment guidelines for AD. Further revisions may be required when new evidence and/or treatments become available.https://annals.edu.sg/updated-consensus-guidelines-for-management-of-moderate-to-severe-atopic-dermatitis-in-singapore-integrating-biologics-janus-kinase-inhibitors-and-conventional-therapies/
spellingShingle Yik Weng Yew
Uma Alagappan
Derrick Aw
Suyien Chandran
Karen JL Choo
Roland Chu
Hong Yi Koh
Mark Jean Aan Koh
Shan Xian Lee
Ching Yin Neoh
Siyun Lucinda Tan
Mark Tang
Yong-Kwang Tay
Seth Francis-Graham
Andrew Lim
Haur Yueh Lee
Updated consensus guidelines for management of moderate-to-severe atopic dermatitis in Singapore: Integrating biologics, Janus kinase inhibitors and conventional therapies
Annals, Academy of Medicine, Singapore
title Updated consensus guidelines for management of moderate-to-severe atopic dermatitis in Singapore: Integrating biologics, Janus kinase inhibitors and conventional therapies
title_full Updated consensus guidelines for management of moderate-to-severe atopic dermatitis in Singapore: Integrating biologics, Janus kinase inhibitors and conventional therapies
title_fullStr Updated consensus guidelines for management of moderate-to-severe atopic dermatitis in Singapore: Integrating biologics, Janus kinase inhibitors and conventional therapies
title_full_unstemmed Updated consensus guidelines for management of moderate-to-severe atopic dermatitis in Singapore: Integrating biologics, Janus kinase inhibitors and conventional therapies
title_short Updated consensus guidelines for management of moderate-to-severe atopic dermatitis in Singapore: Integrating biologics, Janus kinase inhibitors and conventional therapies
title_sort updated consensus guidelines for management of moderate to severe atopic dermatitis in singapore integrating biologics janus kinase inhibitors and conventional therapies
url https://annals.edu.sg/updated-consensus-guidelines-for-management-of-moderate-to-severe-atopic-dermatitis-in-singapore-integrating-biologics-janus-kinase-inhibitors-and-conventional-therapies/
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