1093 Korean treatment guideline of atopic dermatitis

Wednesday, 14 October 2015
Hall D1 Foyer (Floor 3) (Coex Convention Center)

Joo Young Roh, MD , Department of Dermatology, Gil Medical Center, Incheon, South Korea

Jung Eun Kim, MD , Department of Dermatology, St. Paul's Hospital, Seoul, South Korea

Hyun Jeong Kim, MD , Department of Dermatology, Seoul Medical Center, Seoul, South Korea

Bark-Lynn Lew, MD , Department of Dermatology, Kyung Hee University Hospital at Gang-Dong, Seoul, South Korea

Kyung Ho Lee, MD , Department of Dermatology, Bucheon St. Mary's Hospital, Incheon, South Korea

Seung-Phil Hong, MD , Department of Dermatology, Dankook University College of Medicine, Cheonan, South Korea

Yong Hyun Jang, MD , Department of Dermatology, Kyungpook National University, Deagu, South Korea

Kui Young Park, MD , Department of Dermatology, Chung-Ang University Hospital, Seoul, South Korea

Seong Jun Seo, MD.PhD. , Department of Dermatology, Chung-Ang University Hospital, Seoul, South Korea

Jung Min Bae, MD , Department of Dermatology, St. Vincent's Hospital, Seoul, South Korea

Eung Ho Choi, MD , Dermatology, Yonsei University, Wonju College of Medicine, Wonju, South Korea

Ki Beom Suhr, MD , SA Dermatology Clinic, Daejeon, South Korea

Seung Chul Lee, MD , Department of Dermatology, Chonnam National University Hospital, Gwangju, South Korea

Hyun-Chang Ko, MD , Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, South Korea

Young Lip Park, MD , Department of Dermatology, Soonchunhyang University Hospital, Bucheon, South Korea

Sang Wook Son, MD , Dermatology, Korea University, Seoul, South Korea

Young Jun Seo, MD , Department of Dermatology, Chungnam National University Hospital, Daejun, South Korea

Yang Won Lee, MD , Department of Dermatology, Konkuk University Hospital, Seoul, South Korea

Sang Hyun Cho, MD , Department of Dermatology, Incheon St.Mary's Hospital, Seoul, South Korea

Chun Wook Park, MD , Department of Dermatology, Kangnam Sacred Heart Hospital, Seoul, South Korea

A) Background: Treatment guideline of Korean atopic dermatitis was released by Korean Atopic Dermatitis Association(KADA) work group in 2006. Due to the recent advances in atopic dermatitis (AD) research and controlled clinical studies, establishment of updated evidence-based treatment guideline for Korean atopic dermatitis is demanding.

B) Methods: Task force team convened by KADA collected database of references from relevant systematic reviews and guidelines of atopic dermatitis. They raised all the relevant key statements on the management of AD. Evidence of each statement was graded and classified the strength of recommendation for each statement. The evidence of each statement was graded using the classification of the Oxford centre for evidence-based medicine (level 1-level 5). The strength of recommendation was classified as follows;

A, level 1; B, level 2 and 3; C, level 4; D, level 5. Fifty four council members of KADA were asked to vote on the statements of the draft guidelines. Participants indicated their level of agreement with each draft statement using a voting scale of 1–9 (where 1=strong disagreement and 9=strong agreement). Consensus was defined as ≥75% of participants scoring within the 7–9 range (agreement). After three rounds of votes, expert consensus of recommendations were established.

C) Results: Updated guideline provides up-to-date evidence based systematic combined treatment algorithm including basic, proactive, induction and maintenance treatment. In addition, average agreement scores of experts panel were presented considering Korean healthcare system and patients’ adherence. The guideline comprises of the topical management of AD via bathing and skin care, avoidance of exacerbating factors, education and psychosocial support, moisturizer and topical anti-inflammatory drugs, antibiotics, and anti-pruritic drugs and the systemic management of AD including antihistamines, antimicrobials, systemic immunomodulators, allergen-specific immunotherapy (ASIT), phototherapy, and complementary and alternative medicines.  Clinical questions were focused on the therapeutic effect, action plans in detail, side effects, cost effectiveness, and measures to enhance patients’ compliance of each treatment.

D) Conclusions:To achieve high treatment efficacy and patient satisfaction, treatment decisions should be made jointly by the physician and patient. We expect this evidence- and experience-based treatment recommendations of AD experts will be a reference guide for physicians and AD patients choosing the appropriate treatment to improve quality of life and decrease unnecessary social medical costs.