World Atopic Dermatitis Day丨Elevating AD Treatment Goals: MDA Empowers Patients to Achieve Targeted Therapy

Atopic dermatitis (AD) is a chronic, recurrent inflammatory skin disease characterized by persistent eczematous eruptions and intense pruritus.

During public awareness events, many patients report that visible skin lesions often lead to psychological distress, including self-esteem issues, sleep disturbances, and anxiety.

Dengyuemed emphasized, “The severe pruritus associated with AD results in an average annual sleep reduction exceeding 500 hours.

Approximately 35% of moderate-to-severe patients develop anxiety or depression, while direct medical costs can consume 12%-18% of household annual income.

This condition profoundly impacts patients’ physical and mental health and quality of life and imposes substantial economic burdens.”

Breaking the Deadlock in Atopic Dermatitis: MDA Helps Address Unmet Clinical Needs of AD Patients

As a chronic relapsing condition, atopic dermatitis remains incurable and requires long-term management strategies.

While conventional treatment has focused primarily on “lesion control (EASI 50/75),” real-world clinical practice reveals limitations in this approach.

Some patients discontinue medication upon achieving partial relief from itching and visible lesions, overlooking the chronic nature of AD and consequently entering a cycle of “relapse-remission-relapse.”

⚠️This pattern leads to undertreatment, particularly among moderate-to-severe patients who continue to experience significant disease burden.

Research indicates that AD patients prioritize complete lesion clearance and pruritus relief, with most considering “absence of itching” and “rapid lesion improvement” as crucial treatment outcomes.

These expectations highlight the inadequacy of conventional treatment goals and underscore the need for higher therapeutic standards to enable better disease control and long-term management.

Addressing these unmet needs, international experts have proposed the Minimal Disease Activity (MDA) concept to optimize AD management and establish efficacy criteria for systemic therapies.

MDA represents an elevated treatment target incorporating both physician-reported and patient-reported outcomes, aiming for EASI 90 (near-complete lesion clearance) and NRS 0/1 (no or minimal itching).

From Efficacy to Target: MDA Pioneers New Treatment Paradigm for Atopic Dermatitis

The introduction of MDA quantifies AD treatment standards, advancing management strategies from conventional “efficacy” to “target-oriented” care.

Major dermatology departments nationwide, including Huadong Hospital affiliated with Fudan University, are actively implementing the MDA standard.

Professor Shi Lei noted, “For moderate-to-severe AD patients, treatment decisions should involve shared decision-making rather than physician determination alone. Early initiation of target-oriented therapy enables effective disease control, achieves substantial remission, prevents disease progression and systemic complications, and reduces psychological comorbidities.”

MDA integrates multidimensional indicators, including lesion clearance and pruritus control, providing clear, quantifiable treatment targets that advance AD management from EASI 75 to higher standards like EASI 90 and complete itch resolution.

Regarding treatment options, from conventional immunosuppressants and corticosteroids to recently widely adopted IL-4/13 inhibitors and JAK inhibitors, various therapeutic agents demonstrate distinct characteristics in mechanisms, efficacy, and safety profiles.

Professor Shi Lei stressed that only through combining clinical expertise with patients’ actual needs can sustainable and effective treatment pathways be established.

Implementation of MDA standards enables comprehensive multidimensional improvement, granting patients greater life freedom.

For instance, clearance of facial and neck lesions enhances appearance and reduces social anxiety; pruritus relief significantly improves sleep quality and daytime functioning.

Complete skin clearance restores self-confidence and social engagement. By elevating treatment goals to MDA, patients can overcome disease burdens, regain control of their lives, and enjoy enhanced quality of life.

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