Reporting of concomitant and rescue topical therapies in atopic dermatitis randomised controlled trials evaluating a systemic treatment: a scoping review

Abstract

The landscape of atopic dermatitis (AD) treatment has witnessed an exponential increase in randomised controlled trials (RCTs) exploring systemic medications. These trials often incorporate topical therapies either as permitted concomitant treatments or as rescue medications. Variable use of these topicals post-randomisation introduces potential bias as they may nullify or exaggerate treatment responses differentially.

The objective was to determine the proportion of RCTs that clearly report the allowance or prohibition of concomitant and rescue topical treatments. Secondary outcomes involved examining the reporting of specific parameters for these topicals.

We included AD systemic medication RCTs included in the living systematic review of Drucker et al (updated in March 2023). Inclusion criteria were published RCTs evaluating systemic immunomodulatory treatments in eczema. Only anti-inflammatory topical therapies were included as concomitant or rescue topical therapies in this review, emollients were not considered.