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The following is a summary of “Reporting of concomitant and rescue topical therapies in atopic dermatitis randomised controlled trials evaluating a systemic treatment: a scoping review,” published in the January 2025 issue of Dermatology by Leducq et al. 

Recent randomized controlled trials (RCTs) evaluating new systemic treatments for atopic dermatitis (AD) have seen a significant increase over the past decade, often including topical therapies as concomitant or rescue treatments, which could introduce bias by influencing treatment responses.  

Researchers conducted a retrospective study to specify the proportion of RCTs that clearly reported the allowance or prohibition of concomitant and rescue topical treatments, with secondary outcomes focusing on the reporting of key parameters for these treatments.  

They included AD systemic medication RCTs from the living systematic review by Drucker et al. (updated in March 2023, available at the time of this review). The inclusion criteria involved published RCTs evaluating systemic immunomodulatory treatments for AD. Only anti-inflammatory topical therapies were considered, excluding emollients.  

The results showed 83 AD trials were screened, and 67 RCTs published between 1991 and 2023 were included. Most trials reported the allowance or prohibition of concomitant topical treatments (95.5%, N=64/67), but fewer reported rescue topical treatments (73.1%, N=49/67). Among trials permitting concomitant treatments, the type was consistently reported, while details on potency (88.6%, N=31/35), duration (54.3%, N=19/35), application frequency (34.3%, N=12/35), and quantity (5.7%, N=2/35) were less frequent. For trials allowing rescue treatments, the type was specified in 91.2% (N=31/34), but potency (52.9%, N=18/34), duration (8.8%, N=3/34), application frequency (5.9%, N=2/34), and quantity (0%, N=0/34) were often missing. Only 23.5% (N=8/34) clearly reported rescue treatment criteria, with most using “at investigator’s discretion” (61.8%, N=21/34). Multivariable analysis revealed that only the publication year (≥ 2020) was linked to better reporting of rescue treatments (aOR 9.55, 95% CI 1.76–39.8).  

Investigators concluded that while most AD clinical trials of systemic treatments reported concomitant topical treatments, reporting of rescue topicals was inconsistent and inadequate, necessitating a standardized approach to topical therapy reporting to improve transparency and interpretability.

Source: academic.oup.com/bjd/advance-article/doi/10.1093/bjd/ljaf031/7990831