TREatment of ATopic eczema (TREAT) Registry Taskforce
Team: TREAT Registry Taskforce Executive Committee: Carsten Flohr (Principal Investigator, UK), Phyllis Spuls (Principal Investigator, The Netherlands), Christian Apfelbacher (Germany), Alan Irvine (Ireland), and Jochen Schmitt (Germany); and Louise Gerbens, (The Netherlands)
Most patients with atopic eczema can be treated effectively with emollients and topical anti-inflammatory agents. However, the moderate-to-severe cases require more than these treatments to control their disease. In these cases photo- and systemic immunomodulating therapies are used.
The current evidence to guide clinical management for moderate-to-severe atopic eczema is based on a small body of randomized controlled trials and observational studies. There are no long-term, prospective and comparative data on these therapies in children or adults from large-scale multicentre cohort studies. In absence of approved alternatives immunomodulatory therapies are frequently prescribed off-label.
Therefore, to improve quality of care, the TREAT Registry Taskforce aims to capture long-term prospective observational data on the use of photo- and systemic immunomodulating therapies in real-life pediatric and adult patients with atopic eczema in national registries. A standardized methodological approach across participating centres and countries will enhance direct comparability of individual country data and allow data pooling between countries.
There is consensus amongst a multidisciplinary, multinational team of stakeholders on the What (eDelphi and consensus meeting), How and When to measure of a core dataset and a web-based database is being developed.
Website: See https://treat-registry-taskforce.org/
References:
1 The international TREatment of ATopic eczema (TREAT) Registry Taskforce: an initiative to harmonise data collection across national atopic eczema photo- and systemic therapy registries. JID 2017 ncbi.nlm.nih.gov/pubmed/28558913
2 TREatment of ATopic eczema (TREAT) Registry Taskforce: protocol for an international Delphi exercise to identify a core set of domains and domain items for national atopic eczema registries. Trials 2017 trialsjournal.biomedcentral.com/articles/10.1186/s13063-016-1765-7
3 Usage and effectiveness of systemic treatments in adults with severe atopic eczema: First results of the German Atopic Eczema Registry TREATgermany. Journal der Deutschen Dermatologischen Gesellschaft (JDDG) 2017 ncbi.nlm.nih.gov/pubmed/27862987
TREAT surveys
Anecdotally, there is wide variation in treatment approaches between clinicians in the way they treat severe atopic eczema; i.e. eczema that has not responded to conventional topical and/or light therapy. Three surveys have been conducted to gather information on how severe atopic eczema in children in Europe and adults in the UK , Canada and the US is treated, not only to inform clinical practice but also to potentially aid the design of an intervention study with different systemic immunomodulating drugs. Currently, a similar survey is being conducted for adult patients across Europe (supported by the EADV).
References:
1 Proudfoot LE, Powell AM, Ayis S, Barbarot S, Baselga Torres E, Deleuran M, et al. The European TREatment of severe Atopic eczema in children Taskforce (TREAT) survey. Br J Dermatol 2013;169:901-9.
2 Taylor K, Swan DJ, Affleck A, Flohr C, Reynolds NJ, DCTN. cwUTatU. Treatment of moderate-to-severe atopic eczema in adults within the U.K.: results of a national survey of dermatologists. Br J Dermatol 2017;176:1617-1623.
3 Totri CR, Eichenfield LF, Logan K, Proudfoot L, Schmitt J, Lara-Corrales I, et al. Prescribing practices for systemic agents in the treatment of severe pediatric atopic dermatitis in the US and Canada: The PeDRA TREAT survey. J Am Acad Dermatol 2017;76:281-5.