Understanding treatment response in real-world patients with atopic eczema

Atopic eczema is a common and chronic inflammatory skin disorder that is characterized by the presence of pruritic lesions on the skin. It concerns a heterogeneous disease, in which many subgroups of patients (i.e. phenotypes) can be identified. It may present as a mild to a severe disease. A subset of patients with moderate-to-severe atopic eczema requires systemic therapy, such as for example treatment with ciclosporin, methotrexate or dupilumab, in order to achieve sufficient disease control.
There is a lack of evidence regarding many aspects of the systemic therapies that are available for atopic eczema. In particular, good comparative research, research on different subgroups of patients and the long-term (cost-)effectiveness and safety of therapies is lacking. It is not feasible to perform long-term randomized controlled trials to investigate all potential comparisons between treatments and subgroups. In registries, data are collected from patients in daily practice to answer questions in relation to various aspects of treatments, including questions that cannot be properly investigated by means of randomized controlled trials.
In this thesis increasing international standardization and cooperation to investigate treatments for atopic eczema using the TREAT Registry Taskforce and the TREAT NL registry (Part I), real-world experience with dupilumab in atopic eczema (Part II) and phenotypes of atopic eczema (Part III) are discussed and investigated, to contribute to a better understanding of treatment response in patients with atopic eczema in daily practice.