Clinical Scorecard: Global Approaches and Expert Recommendations for Starting Biologics in Atopic Dermatitis: Findings from the AMAZE Project

At a Glance

Key Highlights

• The AMAZE project used a narrative literature review, an online survey, regional expert meetings, and global steering committee input.
• Survey responses from 150 dermatologists worldwide showed substantial variation in biologic initiation and management.
• Clinicians reported varied transition approaches from conventional systemic therapies, including overlap, direct switching, and washout periods.
• Expert opinion identified best practices including patient-centered treatment goals, tailored transition strategies, and response assessment at approximately 12–16 weeks.
• Expert opinion identified continuing background topical therapy to address flares and support sustained long-term disease control as a best practice.

Guideline-Based Recommendations

Diagnosis

• The article addresses biologic initiation and management in moderate-to-severe AD; it does not provide new diagnostic criteria.

Management

• Expert opinion identified defining patient-centered treatment goals as a best practice when initiating biologic therapy.
• Expert opinion identified tailoring transition strategies when switching from conventional systemic immunosuppressives as a best practice; survey respondents reported overlap, direct switching, and washout approaches.
• Expert opinion identified continuing background topical therapy to address flares and support sustained long-term disease control as a best practice.

Monitoring & Follow-up

• Expert opinion identified assessing treatment response at suitable intervals, approximately 12–16 weeks, as a best practice.

Risks

• The article describes limitations of conventional systemic immunosuppressives, including concerns about long-term safety and tolerability such as organ toxicity, and the need for ongoing laboratory surveillance.

Patient & Prescribing Data

The project examined clinician practices for initiating biologics in patients with moderate-to-severe AD, including transitions from conventional systemic immunosuppressive therapy.

Dermatologists reported varied transition approaches and follow-up practices. Expert opinion identified individualized transition planning, patient-centered goals, response assessment at approximately 12–16 weeks, and continued background topical therapy as best practices.

Clinical Best Practices

• Expert opinion identified establishing patient-centered treatment goals when starting a biologic as a best practice.
• Expert opinion identified individualizing transitions from conventional systemic therapy as a best practice; survey respondents reported overlap, direct switching, and washout periods.
• Expert opinion identified assessing response at approximately 12–16 weeks as a best practice.
• Expert opinion identified continuing background topical therapy to address flares and support sustained disease control as a best practice.

Related Resources & Content

• Digital features and graphical plain language summary